Provider Demographics
NPI:1932704061
Name:GUIDING LIGHT COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:GUIDING LIGHT COUNSELING SERVICES, PLLC
Other - Org Name:GUIDING LIGHT COUNSELING SERVICES, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:T
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW-C, LCSW
Authorized Official - Phone:586-610-7226
Mailing Address - Street 1:21 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-5613
Mailing Address - Country:US
Mailing Address - Phone:586-404-4449
Mailing Address - Fax:586-501-1664
Practice Address - Street 1:21 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-5613
Practice Address - Country:US
Practice Address - Phone:586-404-4449
Practice Address - Fax:586-501-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty