| Lighthouse Christian Counseling, Inc. | |
|
410 North 10th Street Richmond IN 47374-3118 | |
| (774) 285-0822 | |
| (765) 530-8099 |
| Full Name | Lighthouse Christian Counseling, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 410 North 10th Street, Richmond, Indiana |
| Authorized Official Name and Position | Elizabeth Jane Moore (PRESIDENT) |
| Authorized Official Contact | 7742850822 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Christian Counseling, Inc. 2514 Oak Park Court Richmond IN 47374-1282 Ph: (774) 285-0822 | Lighthouse Christian Counseling, Inc. 410 North 10th Street Richmond IN 47374-3118 Ph: (774) 285-0822 |
| NPI Number | 1124599311 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 04/04/2019 |
| Medicare PECOS PAC ID | 7012255755 |
|---|---|
| Medicare Enrollment ID | O20190205001881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124599311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Elizabeth J Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871826610 PECOS PAC ID: 2264570860 Enrollment ID: I20141105001015 |
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