Provider Demographics
NPI:1912943903
Name:NORTHLIGHT COUNSELING ASSOCIATES INC
Entity Type:Organization
Organization Name:NORTHLIGHT COUNSELING ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-605-4986
Mailing Address - Street 1:4121 E VALLEY AUTO DR.
Mailing Address - Street 2:SUITE 122
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4631
Mailing Address - Country:US
Mailing Address - Phone:602-285-9696
Mailing Address - Fax:602-277-5930
Practice Address - Street 1:4121 E VALLEY AUTO DR
Practice Address - Street 2:SUITE 122
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4631
Practice Address - Country:US
Practice Address - Phone:602-285-9696
Practice Address - Fax:602-277-5930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty