Provider Demographics
NPI:1881319713
Name:CHILDREN OF NUN'S LIGHTHOUSE TRUE BLUE CHRISTIAN COUNSELING CENTER
Entity type:Organization
Organization Name:CHILDREN OF NUN'S LIGHTHOUSE TRUE BLUE CHRISTIAN COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-754-0069
Mailing Address - Street 1:1500 WIMBERLY CT
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2467
Mailing Address - Country:US
Mailing Address - Phone:817-754-0069
Mailing Address - Fax:
Practice Address - Street 1:2012 SHADY BROOK DR
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-5605
Practice Address - Country:US
Practice Address - Phone:817-754-0069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty