Provider Demographics
NPI:1568854446
Name:LIGHTEN COUNSELING SERVICES
Entity Type:Organization
Organization Name:LIGHTEN COUNSELING SERVICES
Other - Org Name:ENLIGHTENMENT COUNSELLING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KYNTRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGHTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC-S
Authorized Official - Phone:281-570-4523
Mailing Address - Street 1:19703B EASTEX FWY # 56
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3513
Mailing Address - Country:US
Mailing Address - Phone:281-570-4523
Mailing Address - Fax:
Practice Address - Street 1:19706 BOLTON BRIDGE LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-1927
Practice Address - Country:US
Practice Address - Phone:281-570-4523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19226251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171494105Medicaid
TX171494103Medicaid