| Lighthouse Family Counseling | |
|
1216 W Jefferson St Kokomo IN 46901-4341 | |
| (765) 854-6010 | |
| (765) 854-6011 |
| Full Name | Lighthouse Family Counseling |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1216 W Jefferson St, Kokomo, Indiana |
| Authorized Official Name and Position | Scott A Edwards (PRESIDENT) |
| Authorized Official Contact | 7658546010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Family Counseling Po Box 6181 Kokomo IN 46904-6181 Ph: (765) 854-6010 | Lighthouse Family Counseling 1216 W Jefferson St Kokomo IN 46901-4341 Ph: (765) 854-6010 |
| NPI Number | 1356352991 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 12/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356352991 | NPI | - | NPPES |
| 200365360 | Medicaid | IN | |
| 000000504024 | Other | IN | ANTHEM |
| 713933000 | Other | MAGELLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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