Provider Demographics
NPI:1073295259
Name:ONE MORE LIGHT COUNSELING & WELLNESS LLC
Entity Type:Organization
Organization Name:ONE MORE LIGHT COUNSELING & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:CAGGIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSFP, MSW
Authorized Official - Phone:321-800-8439
Mailing Address - Street 1:201 WINDEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-5536
Mailing Address - Country:US
Mailing Address - Phone:321-800-8439
Mailing Address - Fax:
Practice Address - Street 1:819 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3131
Practice Address - Country:US
Practice Address - Phone:321-800-8439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)