Provider Demographics
NPI:1003697418
Name:SEA THE LIGHT COUNSELING, LLC
Entity Type:Organization
Organization Name:SEA THE LIGHT COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SABRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIHM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:908-910-6000
Mailing Address - Street 1:841 ETHAN CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3600
Mailing Address - Country:US
Mailing Address - Phone:908-910-6000
Mailing Address - Fax:
Practice Address - Street 1:841 ETHAN CT
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3600
Practice Address - Country:US
Practice Address - Phone:908-910-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty