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General NPI Number Information
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NPI Number | 1396246922
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Entity Type | Organization
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Legal Business Name | LAMPLIGHT COUNSELING, LLC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 02/28/2018
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Provider Practice Location Address
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Address Line | 15 YORK ST UNIT 201H
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City | BIDDEFORD
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State | ME
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Zip | 04005-5531
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Country | US
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Telephone | 207-200-1097
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Fax |
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Provider Business Mailing Address
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Address Line | 51 WILD DUNES WAY UNIT 13
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City | OLD ORCHARD BEACH
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State | ME
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Zip | 04064-4156
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Country | US
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Telephone | 207-317-0049
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MASHELLE LOUISE KRIER
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Credential | LCPC-C
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Telephone | 207-317-0049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | XL4797
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License Number State | ME
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