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General NPI Number Information
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NPI Number | 1689537516
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Entity Type | Organization
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Legal Business Name | ENLIGHT PSYCHOLOGICAL & ASSESSMENT SERVICES, PLLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 200 DOCTORS DR STE M
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6308
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Country | US
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Telephone | 910-526-0326
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Fax | 910-954-1449
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Provider Business Mailing Address
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Address Line | 103 TEAL CT
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City | SNEADS FERRY
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State | NC
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Zip | 28460-7616
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Country | US
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Telephone | 540-273-8498
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE MARRO
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Credential | MA, LPA
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Telephone | 540-273-8498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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