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General NPI Number Information
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NPI Number | 1730593328
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Entity Type | Organization
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Legal Business Name | THE LIGHT OF THE WORLD MINISTRY
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 06/11/2014
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Provider Practice Location Address
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Address Line | 3520 LINCOLN AVE STE 4
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City | OGDEN
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State | UT
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Zip | 84401-4002
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Country | US
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Telephone | 888-332-3566
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Fax | 866-429-3836
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Provider Business Mailing Address
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Address Line | 2144 S LAKELINE DR
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City | SALT LAKE CITY
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State | UT
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Zip | 84109-1425
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Country | US
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Telephone | 801-486-0908
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Fax | 801-998-3302
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | VAUGHN STEWART MILLIRON
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Credential | M.DIV.
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Telephone | 801-486-0908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 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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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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