Provider Demographics
NPI:1396227039
Name:LANTERN FAMILY SERVICES INC
Entity Type:Organization
Organization Name:LANTERN FAMILY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MPS, JD, LCPC
Authorized Official - Phone:301-266-6861
Mailing Address - Street 1:1282 SMALLWOOD DR W STE 507
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4732
Mailing Address - Country:US
Mailing Address - Phone:301-266-6861
Mailing Address - Fax:240-607-2776
Practice Address - Street 1:11680 DOOLITTLE DR STE 111
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:240-607-2756
Practice Address - Fax:240-607-2776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2150251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health