Provider Demographics
NPI:1477199941
Name:LIGHTHOUSE FAMILY COUNSELING, LLC
Entity type:Organization
Organization Name:LIGHTHOUSE FAMILY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:DONOHOO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:563-343-6817
Mailing Address - Street 1:1800 3RD AVE STE 517
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-8019
Mailing Address - Country:US
Mailing Address - Phone:563-293-5100
Mailing Address - Fax:
Practice Address - Street 1:1800 3RD AVE STE 517
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-8019
Practice Address - Country:US
Practice Address - Phone:563-293-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty