| Lighthouse Professional Counseling Services, Llc | |
|
1111 Paine St Suite D Decorah IA 52101-2411 | |
| (563) 382-1900 | |
| (563) 382-1777 |
| Full Name | Lighthouse Professional Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1111 Paine St, Decorah, Iowa |
| Authorized Official Name and Position | Mary C. Atkinson (OWNER) |
| Authorized Official Contact | 5633821900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Professional Counseling Services, Llc 1111 Paine St Suite D Decorah IA 52101-2411 Ph: (563) 382-1900 | Lighthouse Professional Counseling Services, Llc 1111 Paine St Suite D Decorah IA 52101-2411 Ph: (563) 382-1900 |
| NPI Number | 1598939407 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 09/03/2015 |
| Medicare PECOS PAC ID | 3274841630 |
|---|---|
| Medicare Enrollment ID | O20151005000858 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598939407 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Iowa) | Primary |
| Provider Name | Dennis Lee Millage |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881242444 PECOS PAC ID: 5799169090 Enrollment ID: I20220906002496 |
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