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General NPI Number Information
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NPI Number | 1396438297
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Entity Type | Organization
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Legal Business Name | LIGHTING MY PATH LLC
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Dates
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Enumeration Date | 05/29/2023
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Last Update Date | 05/29/2023
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Provider Practice Location Address
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Address Line | 25 ALSAB CT
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City | BALTIMORE
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State | MD
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Zip | 21244-1429
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Country | US
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Telephone | 443-840-7099
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Fax |
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Provider Business Mailing Address
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Address Line | 4 MILFORD GARDEN CT
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City | BALTIMORE
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State | MD
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Zip | 21244-2978
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Country | US
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Telephone | 443-840-7099
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | RUTH DJARBENG
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Credential | LCSW-C
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Telephone | 443-840-7099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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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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