Provider Demographics
NPI:1184022477
Name:LIGHTHOUSE COUNSELING SOLUTIONS
Entity Type:Organization
Organization Name:LIGHTHOUSE COUNSELING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:TERRENCE
Authorized Official - Last Name:HEFFERAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC, NCC
Authorized Official - Phone:919-913-8323
Mailing Address - Street 1:7019 HARPS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3248
Mailing Address - Country:US
Mailing Address - Phone:919-913-8323
Mailing Address - Fax:
Practice Address - Street 1:7019 HARPS MILL RD
Practice Address - Street 2:SUTIE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3248
Practice Address - Country:US
Practice Address - Phone:919-913-8323
Practice Address - Fax:919-850-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7094106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1942479340OtherNPI