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General NPI Number Information
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NPI Number | 1922592559
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE COUNSELING & TESTING SERVICES, PLLC
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 805 SUPERIOR ST STE A
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City | PORT HURON
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State | MI
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Zip | 48060
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Country | US
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Telephone | 810-996-1972
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Fax | 810-996-1973
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Provider Business Mailing Address
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Address Line | 805 SUPERIOR ST STE A
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City | PORT HURON
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State | MI
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Zip | 48060-3771
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Country | US
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Telephone | 810-996-1972
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Fax | 810-996-1973
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Authorized Official
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Title or Position | OWNER
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Name | LISA GREY
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Credential |
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Telephone | 810-996-1972
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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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