Provider Demographics
NPI:1386036861
Name:M. R. LIGHTHOUSE COUNSELING AND CONSULTING SERVICES, LLC
Entity Type:Organization
Organization Name:M. R. LIGHTHOUSE COUNSELING AND CONSULTING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL CLINICAL COUN
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:937-239-3465
Mailing Address - Street 1:548 W ALEX BELL RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3050
Mailing Address - Country:US
Mailing Address - Phone:937-239-3465
Mailing Address - Fax:937-648-5314
Practice Address - Street 1:548 W ALEX BELL RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3050
Practice Address - Country:US
Practice Address - Phone:937-239-3465
Practice Address - Fax:937-648-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty