Provider Demographics
NPI:1851689194
Name:LIGHTHOUSE COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARB
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:610-937-7801
Mailing Address - Street 1:401 W. FRONT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063
Mailing Address - Country:US
Mailing Address - Phone:610-937-7801
Mailing Address - Fax:
Practice Address - Street 1:401 W FRONT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2634
Practice Address - Country:US
Practice Address - Phone:610-937-7801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)