| Light Counseling Center | |
|
9124 Gravelly Lake Dr Sw Lakes Plaza Suite 101 Lakewood WA 98499-3198 | |
| (253) 503-0236 | |
| (253) 503-0982 |
| Full Name | Light Counseling Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9124 Gravelly Lake Dr Sw, Lakewood, Washington |
| Authorized Official Name and Position | Jennifer Hortense Ferguson (CEO) |
| Authorized Official Contact | 2535030236 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Light Counseling Center 9124 Gravelly Lake Dr Sw Lakes Plaza Suite 101 Lakewood WA 98499-3198 Ph: (253) 503-0236 | Light Counseling Center 9124 Gravelly Lake Dr Sw Lakes Plaza Suite 101 Lakewood WA 98499-3198 Ph: (253) 503-0236 |
| NPI Number | 1033488598 |
|---|---|
| Provider Enumeration Date | 12/29/2011 |
| Last Update Date | 12/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033488598 | NPI | - | NPPES |
| 331-8907 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 602933664 (Washington) | Primary |
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