Provider Demographics
NPI:1841359270
Name:LIGHTHOUSE COUNSELING, LTD.
Entity type:Organization
Organization Name:LIGHTHOUSE COUNSELING, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BENGTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSE, LPCC
Authorized Official - Phone:855-454-2463
Mailing Address - Street 1:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350-0655
Mailing Address - Country:US
Mailing Address - Phone:855-454-2463
Mailing Address - Fax:320-295-7898
Practice Address - Street 1:121 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350-2514
Practice Address - Country:US
Practice Address - Phone:855-454-2463
Practice Address - Fax:320-295-7898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
MNCC00105101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty