Provider Demographics
NPI:1891283255
Name:A AND K ENTERPRISES INC
Entity Type:Organization
Organization Name:A AND K ENTERPRISES INC
Other - Org Name:LIGHTHOUSE COUNSELING AND MEDIATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, LICDC-CS
Authorized Official - Phone:330-853-6523
Mailing Address - Street 1:30697 KING RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-9531
Mailing Address - Country:US
Mailing Address - Phone:330-853-6523
Mailing Address - Fax:740-314-5527
Practice Address - Street 1:320 MARKET ST FL 3
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2153
Practice Address - Country:US
Practice Address - Phone:740-314-5339
Practice Address - Fax:740-314-5527
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A AND KE ENTERPRISES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-01
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH081188101YA0400X
OHE0600491101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0210495Medicaid