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General NPI Number Information
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NPI Number | 1922894690
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Entity Type | Organization
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Legal Business Name | CIRCLE OF LIGHT CONSULTING, LLC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 657 LONE OAK RD STE 1
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City | PADUCAH
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State | KY
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Zip | 42003-4547
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Country | US
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Telephone | 850-258-3285
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Fax | 888-508-2205
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Provider Business Mailing Address
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Address Line | 657 LONE OAK RD STE 1
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City | PADUCAH
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State | KY
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Zip | 42003-4547
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Country | US
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Telephone | 850-258-3285
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Fax | 888-508-2205
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Authorized Official
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Title or Position | INTERIM DIRECTOR
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Name | JESSIE BARBER
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Credential |
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Telephone | 850-258-3285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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