| Lighthouse Counseling Pc | |
|
121 Jackson Street Newnan GA 30263 | |
| (770) 251-5873 | |
| (770) 304-2201 |
| Full Name | Lighthouse Counseling Pc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 07/24/2007 |
| Medicare PECOS PAC ID | 3577551738 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114985785 PECOS PAC ID: 4082629688 Enrollment ID: I20111110000184 |
| Provider Name | Kimberly B Alford |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730526021 PECOS PAC ID: 5698990901 Enrollment ID: I20140630001300 |
| Provider Name | Sarah B Lyle |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740764851 PECOS PAC ID: 2466706361 Enrollment ID: I20181113000377 |
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