Provider Demographics
NPI:1033738406
Name:LIGHTHOUSE COUNSELING CENTER LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LJUBINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:STANISAVLJEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-886-6645
Mailing Address - Street 1:143 S LINCOLN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-4290
Mailing Address - Country:US
Mailing Address - Phone:630-277-9608
Mailing Address - Fax:
Practice Address - Street 1:143 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4263
Practice Address - Country:US
Practice Address - Phone:847-840-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty