| Lighthouse Therapeutic Services, Llc | |
|
14201 Governor Lee Pl Upper Marlboro MD 20772-5902 | |
| (202) 236-0727 | |
| Not Available |
| Full Name | Lighthouse Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 14201 Governor Lee Pl, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Taz Barnes (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2022360727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Therapeutic Services, Llc 14201 Governor Lee Pl Upper Marlboro MD 20772-5902 Ph: (202) 236-0727 | Lighthouse Therapeutic Services, Llc 14201 Governor Lee Pl Upper Marlboro MD 20772-5902 Ph: (202) 236-0727 |
| NPI Number | 1831760719 |
|---|---|
| Provider Enumeration Date | 07/01/2021 |
| Last Update Date | 07/01/2021 |
| Certification Date | 11/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831760719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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