Provider Demographics
NPI:1003688714
Name:LIGHTHOUSE COUNSELING SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:LIGHTHOUSE COUNSELING SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRGIOLAITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-316-0325
Mailing Address - Street 1:2501 CHATHAM RD STE 8089
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-4188
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2501 CHATHAM RD STE 8089
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-4188
Practice Address - Country:US
Practice Address - Phone:847-316-0325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty