Provider Demographics
NPI:1619486578
Name:GUIDING LIGHT CONCEPTS LLC
Entity Type:Organization
Organization Name:GUIDING LIGHT CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:808-393-3973
Mailing Address - Street 1:413 E LITTLE DIPPER
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-6427
Mailing Address - Country:US
Mailing Address - Phone:808-393-3973
Mailing Address - Fax:
Practice Address - Street 1:310 W CENTRAL TEXAS EXPY STE 1
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-2573
Practice Address - Country:US
Practice Address - Phone:808-393-3973
Practice Address - Fax:808-393-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty