Provider Demographics
NPI:1881201192
Name:GUIDING LIGHT MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:GUIDING LIGHT MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-820-2022
Mailing Address - Street 1:400 TEXAS ST STE 1050-06
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3525
Mailing Address - Country:US
Mailing Address - Phone:318-820-2022
Mailing Address - Fax:318-771-7852
Practice Address - Street 1:400 TEXAS ST STE 1050-06
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3525
Practice Address - Country:US
Practice Address - Phone:318-820-2022
Practice Address - Fax:318-771-7852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty