Provider Demographics
NPI:1740040203
Name:FROM DARKNESS TO LIGHT PROPHETIC COUNSELING LLC
Entity type:Organization
Organization Name:FROM DARKNESS TO LIGHT PROPHETIC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOSELEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC-S, NCC
Authorized Official - Phone:726-842-0498
Mailing Address - Street 1:21750 HARDY OAK BLVD. STE. 104
Mailing Address - Street 2:#660606
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:726-842-0498
Mailing Address - Fax:
Practice Address - Street 1:1380 PANTHEON WAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2288
Practice Address - Country:US
Practice Address - Phone:726-842-0498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)