Provider Demographics
NPI:1225740889
Name:LIGHT OF OF HOPE COUNSELING BILINGUAL
Entity Type:Organization
Organization Name:LIGHT OF OF HOPE COUNSELING BILINGUAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GODINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MFT 4153
Authorized Official - Phone:702-831-7290
Mailing Address - Street 1:4760 S PECOS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5828
Mailing Address - Country:US
Mailing Address - Phone:702-831-7290
Mailing Address - Fax:
Practice Address - Street 1:4760 S PECOS RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5828
Practice Address - Country:US
Practice Address - Phone:702-831-7290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty