Provider Demographics
NPI:1083494454
Name:GUIDING LIGHT PSYCHIATRY, INC
Entity Type:Organization
Organization Name:GUIDING LIGHT PSYCHIATRY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:177-432-8171
Mailing Address - Street 1:77 HILLER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02770-4031
Mailing Address - Country:US
Mailing Address - Phone:177-432-8171
Mailing Address - Fax:
Practice Address - Street 1:73 MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:CARVER
Practice Address - State:MA
Practice Address - Zip Code:02330-1090
Practice Address - Country:US
Practice Address - Phone:774-328-1712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty