| Lighthouse Counseling Center And Associated Therapeutic Services, Llc | |
|
901 Arsenal Ave Ste 202 Fayetteville NC 28305-5478 | |
| (910) 323-3368 | |
| (910) 486-7000 |
| Full Name | Lighthouse Counseling Center And Associated Therapeutic Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 901 Arsenal Ave Ste 202, Fayetteville, North Carolina |
| Authorized Official Name and Position | Chester Michael Martin (ADMINISTRATOR) |
| Authorized Official Contact | 9103233368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Counseling Center And Associated Therapeutic Services, Llc 901 Arsenal Ave Suite 202 Fayetteville NC 28305-5398 Ph: (910) 323-3368 | Lighthouse Counseling Center And Associated Therapeutic Services, Llc 901 Arsenal Ave Ste 202 Fayetteville NC 28305-5478 Ph: (910) 323-3368 |
| NPI Number | 1316180565 |
|---|---|
| Provider Enumeration Date | 04/16/2009 |
| Last Update Date | 12/08/2022 |
| Certification Date | 12/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316180565 | NPI | - | NPPES |
| 6008209 | Medicaid | NC | |
| 8301795 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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