| Lighthouse Counseling, Pllc | |
|
2109 19th St Gulfport MS 39501-2918 | |
| (228) 238-0992 | |
| Not Available |
| Full Name | Lighthouse Counseling, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 2109 19th St, Gulfport, Mississippi |
| Authorized Official Name and Position | Christina James (OWNER) |
| Authorized Official Contact | 2282380992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Counseling, Pllc Po Box 1343 Ocean Springs MS 39566-1343 Ph: (228) 238-0992 | Lighthouse Counseling, Pllc 2109 19th St Gulfport MS 39501-2918 Ph: (228) 238-0992 |
| NPI Number | 1235774589 |
|---|---|
| Provider Enumeration Date | 11/11/2019 |
| Last Update Date | 03/30/2023 |
| Certification Date | 03/30/2023 |
| Medicare PECOS PAC ID | 3870927007 |
|---|---|
| Medicare Enrollment ID | O20191223000076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235774589 | NPI | - | NPPES |
| 008430321 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Christina B James |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104461417 PECOS PAC ID: 4789018912 Enrollment ID: I20191223000098 |
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