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General NPI Number Information
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NPI Number | 1902768674
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Entity Type | Organization
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Legal Business Name | SALT AND LIGHT COUNSELING LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1951 MESQUITE AVE STE J
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5746
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Country | US
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Telephone | 928-230-7294
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 MESQUITE AVE STE J
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5746
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Country | US
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Telephone | 928-230-7294
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL SOCIAL WORKER
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Name | OLIVIA R HUARD
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Credential | LCSW
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Telephone | 909-533-1181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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