| NPI | 1508593377 |
|---|---|
| Doing Business As | LIGHTHOUSETHERAPY, LLC |
| Entity Type | Organization |
| Authorized Contact | EVAN MOORE Founder/Owner 833-749-3549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 261Q00000X | |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2022-09-15 |