| Lighthouse Counseling Center Llc | |
|
4728 Jefferson Hwy Jefferson LA 70121-3125 | |
| (504) 734-0501 | |
| Not Available |
| Full Name | Lighthouse Counseling Center Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4728 Jefferson Hwy, Jefferson, Louisiana |
| Authorized Official Name and Position | Nicholas Ben Licata (OWNER) |
| Authorized Official Contact | 5047340501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Counseling Center Llc 4728 Jefferson Highway Jefferson LA 70121 Ph: (504) 734-0501 | Lighthouse Counseling Center Llc 4728 Jefferson Hwy Jefferson LA 70121-3125 Ph: (504) 734-0501 |
| NPI Number | 1245476696 |
|---|---|
| Provider Enumeration Date | 01/06/2009 |
| Last Update Date | 08/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245476696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2910 (Louisiana) | Primary |
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