Provider Demographics
NPI:1528561628
Name:SHINING LIGHT COUNSELING, LLC
Entity Type:Organization
Organization Name:SHINING LIGHT COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:586-243-7175
Mailing Address - Street 1:364 HUNTINGTON CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-3439
Mailing Address - Country:US
Mailing Address - Phone:586-243-7175
Mailing Address - Fax:
Practice Address - Street 1:48465 VAN DYKE AVE STE A
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48317-3272
Practice Address - Country:US
Practice Address - Phone:586-488-3175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty