Lighthouse Counseling Pc | |
121 Jackson Street Newnan GA 30263 | |
(770) 251-5873 | |
(770) 304-2201 |
Full Name | Lighthouse Counseling Pc |
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Speciality | Counselor |
Location | 121 Jackson Street, Newnan, Georgia |
Authorized Official Name and Position | Thomas S Freeman (OWNER PRESIDENT) |
Authorized Official Contact | 7702515873 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lighthouse Counseling Pc 121 Jackson Street Newnan GA 30263 Ph: (770) 251-5873 | Lighthouse Counseling Pc 121 Jackson Street Newnan GA 30263 Ph: (770) 251-5873 |
NPI Number | 1205961232 |
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Provider Enumeration Date | 02/22/2007 |
Last Update Date | 07/24/2007 |
Medicare PECOS PAC ID | 3577551738 |
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Medicare Enrollment ID | O20040505000757 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205961232 | NPI | - | NPPES |
00727658C | Medicaid | GA | |
00458818D | Medicaid | GA | |
00964598A | Medicaid | GA |
Provider Name | Thomas Smith Freeman |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1114985785 PECOS PAC ID: 4082629688 Enrollment ID: I20111110000184 |
Provider Name | Kimberly B Alford |
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Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1730526021 PECOS PAC ID: 5698990901 Enrollment ID: I20140630001300 |
Provider Name | Sarah B Lyle |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1740764851 PECOS PAC ID: 2466706361 Enrollment ID: I20181113000377 |
Provider Name | Rebekah Hope Dingler |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1447507918 PECOS PAC ID: 1759720899 Enrollment ID: I20240422002687 |
Provider Name | Sandra Lynne Jackson |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1881350551 PECOS PAC ID: 0042652034 Enrollment ID: I20240522001519 |
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