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General NPI Number Information
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NPI Number | 1639799661
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Entity Type | Organization
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Legal Business Name | BRIGHT LIGHT COUNSELING PLLC
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Dates
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Enumeration Date | 04/20/2020
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 112 W 4TH AVE
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City | RED SPRINGS
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State | NC
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Zip | 28377-1508
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Country | US
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Telephone | 910-802-2008
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Fax |
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Provider Business Mailing Address
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Address Line | 112 W 4TH AVE
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City | RED SPRINGS
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State | NC
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Zip | 28377-1508
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Country | US
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Telephone | 910-802-2008
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JACQUELINE L CARTHEN
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Credential | LCMHCS
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Telephone | 910-733-2155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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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 | 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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