Provider Demographics
NPI:1770115008
Name:BRIGHT HOUSE COUNSELING AND COACHING LLC
Entity type:Organization
Organization Name:BRIGHT HOUSE COUNSELING AND COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:ELTON
Authorized Official - Last Name:BRIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-819-8918
Mailing Address - Street 1:1303 CLOVER VALLEY WAY APT C
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-2165
Mailing Address - Country:US
Mailing Address - Phone:443-819-8918
Mailing Address - Fax:
Practice Address - Street 1:1303 CLOVER VALLEY WAY APT C
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-2165
Practice Address - Country:US
Practice Address - Phone:443-819-8918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)