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General NPI Number Information
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NPI Number | 1861931826
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Entity Type | Organization
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Legal Business Name | LIGHT OF LIFE COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 6500 S MILLER RD
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City | BUCKEYE
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State | AZ
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Zip | 85326-1503
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Country | US
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Telephone | 623-628-8788
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Fax | 928-286-5158
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Provider Business Mailing Address
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Address Line | 51 E MONROE AVE UNIT 1291
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City | BUCKEYE
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State | AZ
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Zip | 85326-7551
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Country | US
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Telephone | 623-628-8788
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Fax | 928-286-5158
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ULISES GONZALEZ
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Credential | MAPC, LPC, LMFT
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Telephone | 623-628-8788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | AZ
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