Provider Demographics
NPI:1235216219
Name:LIGHTHOUSE COUNSELING, P.C.
Entity Type:Organization
Organization Name:LIGHTHOUSE COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:815-634-3994
Mailing Address - Street 1:275 S BROADWAY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COAL CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60416-1699
Mailing Address - Country:US
Mailing Address - Phone:815-634-3994
Mailing Address - Fax:815-634-2738
Practice Address - Street 1:275 S BROADWAY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:COAL CITY
Practice Address - State:IL
Practice Address - Zip Code:60416-1699
Practice Address - Country:US
Practice Address - Phone:815-634-3994
Practice Address - Fax:815-634-2738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL060007893101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty