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General NPI Number Information
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NPI Number | 1285367565
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Entity Type | Organization
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Legal Business Name | LIGHT AND LOVE COUNSELING GROUP LLC
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Dates
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Enumeration Date | 07/05/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 4100 MARKET ST STE 100
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City | HUNTSVILLE
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State | AL
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Zip | 35808-3007
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Country | US
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Telephone | 256-200-2153
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 GOLDEN RING RD UNIT 9564
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City | ROSEDALE
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State | MD
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Zip | 21237-7603
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Country | US
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Telephone | 410-497-5173
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING CONSULTANT
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Name | MS. TERRI FIELDS
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Credential | CTLC, CPC, CPAC
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Telephone | 410-497-5173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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