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General NPI Number Information
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NPI Number | 1912863135
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Entity Type | Organization
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Legal Business Name | GUIDING LIGHT THERAPY, LLC
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Dates
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Enumeration Date | 12/31/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 1110 SE ALDER ST STE 301
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City | PORTLAND
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State | OR
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Zip | 97214-2400
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Country | US
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Telephone | 971-421-8660
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 NE 144TH AVE
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City | PORTLAND
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State | OR
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Zip | 97230-4117
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Country | US
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Telephone | 971-421-8660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAKEN NELSON
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Credential | LPC
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Telephone | 971-421-8660
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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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