Provider Demographics
NPI:1093587958
Name:SHINING LIGHT COUNSELING LLC
Entity Type:Organization
Organization Name:SHINING LIGHT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMODY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:602-456-4074
Mailing Address - Street 1:16427 N SCOTTSDALE RD STE 410
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-7102
Mailing Address - Country:US
Mailing Address - Phone:602-456-4074
Mailing Address - Fax:
Practice Address - Street 1:16427 N SCOTTSDALE RD STE 410
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-7102
Practice Address - Country:US
Practice Address - Phone:602-456-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty