| Mara's Lighthouse Counseling Center, Llc | |
|
6015 Morrow St E Ste 109 Jacksonville FL 32217-2125 | |
| (904) 990-8105 | |
| (904) 562-3359 |
| Full Name | Mara's Lighthouse Counseling Center, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6015 Morrow St E Ste 109, Jacksonville, Florida |
| Authorized Official Name and Position | Stephanie Ingenito (CREDENTIALING SPECIALISTS) |
| Authorized Official Contact | 5703523063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mara's Lighthouse Counseling Center, Llc 6015 Morrow St E Ste 109 Jacksonville FL 32217-2125 Ph: (904) 990-8105 | Mara's Lighthouse Counseling Center, Llc 6015 Morrow St E Ste 109 Jacksonville FL 32217-2125 Ph: (904) 990-8105 |
| NPI Number | 1962974766 |
|---|---|
| Provider Enumeration Date | 12/19/2018 |
| Last Update Date | 12/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962974766 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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