Provider Demographics
NPI:1164203089
Name:LIGHTED PATHS COUNSELING LLC
Entity Type:Organization
Organization Name:LIGHTED PATHS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MINTURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-315-8964
Mailing Address - Street 1:3321 TUCKER ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-1711
Mailing Address - Country:US
Mailing Address - Phone:402-315-8964
Mailing Address - Fax:
Practice Address - Street 1:3321 TUCKER ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-1711
Practice Address - Country:US
Practice Address - Phone:402-315-8964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty