Provider Demographics
NPI:1912458902
Name:LISA SHOHEN
Entity Type:Organization
Organization Name:LISA SHOHEN
Other - Org Name:LIGHT THE WAY COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SHOHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:201-815-1466
Mailing Address - Street 1:317 GODWIN AVENUE
Mailing Address - Street 2:LIGHT THE WAY COUNSELING CENTER, 3RD FLOOR
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1903
Mailing Address - Country:US
Mailing Address - Phone:201-815-1466
Mailing Address - Fax:
Practice Address - Street 1:317 GODWIN AVE
Practice Address - Street 2:LIGHT THE WAY COUNSELING CENTER, 3RD FLOOR
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1519
Practice Address - Country:US
Practice Address - Phone:201-815-1466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00476900101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty