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General NPI Number Information
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NPI Number | 1225763626
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Entity Type | Organization
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Legal Business Name | LIGHTING LIVES COUNSELING LLC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 250 POMEROY AVE STE 201D
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City | MERIDEN
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State | CT
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Zip | 06450-8316
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Country | US
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Telephone | 860-940-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 380 GLEN HILLS RD
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City | MERIDEN
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State | CT
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Zip | 06451-3836
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Country | US
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Telephone | 860-940-1410
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JESSICA M MARKURE
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Credential | LCSW
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Telephone | 860-940-1410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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