Provider Demographics
NPI:1558534305
Name:LIGHTHOUSE THERAPY CENTER
Entity Type:Organization
Organization Name:LIGHTHOUSE THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ALIOTO
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-732-1310
Mailing Address - Street 1:30838 VINES CREEK RD
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939-4385
Mailing Address - Country:US
Mailing Address - Phone:302-732-1310
Mailing Address - Fax:
Practice Address - Street 1:30838 VINES CREEK RD
Practice Address - Street 2:SUITE 2B
Practice Address - City:DAGSBORO
Practice Address - State:DE
Practice Address - Zip Code:19939-4385
Practice Address - Country:US
Practice Address - Phone:302-732-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00008201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty