Provider Demographics
NPI:1841890175
Name:GUIDING LIGHT MENTAL HEALTH PC
Entity type:Organization
Organization Name:GUIDING LIGHT MENTAL HEALTH PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-565-5154
Mailing Address - Street 1:501 E FRONT ST STE 517
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5209
Mailing Address - Country:US
Mailing Address - Phone:406-565-5154
Mailing Address - Fax:406-565-5040
Practice Address - Street 1:501 E FRONT ST STE 517
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-5209
Practice Address - Country:US
Practice Address - Phone:406-565-5154
Practice Address - Fax:406-565-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty