Provider Demographics
NPI:1457091340
Name:THE LIGHTCHASER INSTITUTE, LLC
Entity Type:Organization
Organization Name:THE LIGHTCHASER INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGHTCHASER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:240-558-0200
Mailing Address - Street 1:4723B REELS MILL RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-7324
Mailing Address - Country:US
Mailing Address - Phone:443-928-0198
Mailing Address - Fax:
Practice Address - Street 1:1 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5991
Practice Address - Country:US
Practice Address - Phone:240-558-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty