Provider Demographics
NPI:1871186718
Name:LIGHTSHIP FAMILY COUNSELING, LLC
Entity Type:Organization
Organization Name:LIGHTSHIP FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CASSAUNDRA
Authorized Official - Middle Name:E
Authorized Official - Last Name:POPEK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, ERPSCC, PMH-C
Authorized Official - Phone:860-331-9548
Mailing Address - Street 1:PO BOX 1258
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-4458
Mailing Address - Country:US
Mailing Address - Phone:860-331-9548
Mailing Address - Fax:860-969-2939
Practice Address - Street 1:24 BATTLE ST STE 2A
Practice Address - Street 2:
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1629
Practice Address - Country:US
Practice Address - Phone:860-331-9548
Practice Address - Fax:860-969-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-11
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty