Provider Demographics
NPI:1821442070
Name:LIGHTHOUSE COUNSELING ASSOCIATES
Entity type:Organization
Organization Name:LIGHTHOUSE COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:THIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:774-644-0483
Mailing Address - Street 1:3047 E MAIN RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871-4263
Mailing Address - Country:US
Mailing Address - Phone:401-684-1787
Mailing Address - Fax:833-339-3848
Practice Address - Street 1:3047 E MAIN RD STE 2
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4263
Practice Address - Country:US
Practice Address - Phone:401-684-1787
Practice Address - Fax:833-339-3848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW019811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty