MEDICARE: GUIDING LIGHT MENTORING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	106H00000X	Marriage & Family Therapist
2	163W00000X	Registered Nurse
3	101Y00000X	Counselor
4	1041C0700X	Clinical Social Worker
5	251V00000X	Voluntary or Charitable Agency	OH
6	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1013456177
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDING LIGHT MENTORING

Provider Business Mailing Address
First Line	:	6240 HAMILTON AVE STE 4
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2000
Country	:	US
Telephone Number	:	513-541-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	6240 HAMILTON AVE STE 4
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2000
Country	:	US
Telephone Number	:	513-541-9777
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LATISHA ALISHA OWENS
Credential	:
Telephone Number	:	513-508-2029

Provider Enumeration Date	:	02/21/2017
Last Update Date	:	10/01/2024

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Directions to “GUIDING LIGHT MENTORING ” Practice Location

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