Provider Demographics
NPI:1700526704
Name:LOVING LIGHT COUNSELING, LLC
Entity Type:Organization
Organization Name:LOVING LIGHT COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTHET
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-392-5042
Mailing Address - Street 1:23826 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-1488
Mailing Address - Country:US
Mailing Address - Phone:248-392-5042
Mailing Address - Fax:877-470-7354
Practice Address - Street 1:23550 HARPER AVE STE 322
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1447
Practice Address - Country:US
Practice Address - Phone:313-799-2124
Practice Address - Fax:877-470-7354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty