Provider Demographics
NPI:1285178491
Name:LIGHT OF HOPE COUNSELING SERVICES
Entity Type:Organization
Organization Name:LIGHT OF HOPE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAGHICHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:951-288-9086
Mailing Address - Street 1:108 ORANGE ST STE 8
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-4719
Mailing Address - Country:US
Mailing Address - Phone:951-288-9086
Mailing Address - Fax:
Practice Address - Street 1:108 ORANGE ST STE 8
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4719
Practice Address - Country:US
Practice Address - Phone:951-288-9086
Practice Address - Fax:909-363-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW67830251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health