| The Light Program, Inc. | |
|
1440 Russell Rd Paoli PA 19301-1236 | |
| (814) 552-0229 | |
| (610) 644-4066 |
| Full Name | The Light Program, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1440 Russell Rd, Paoli, Pennsylvania |
| Authorized Official Name and Position | Debbie Sattler (EMR HELPDESK SUPERVISOR) |
| Authorized Official Contact | 8145520229 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Light Program, Inc. 700 American Ave Ste 201 King Of Prussia PA 19406-4031 Ph: (814) 552-0229 | The Light Program, Inc. 1440 Russell Rd Paoli PA 19301-1236 Ph: (814) 552-0229 |
| NPI Number | 1396766333 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 01/14/2025 |
| Certification Date | 01/14/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396766333 | NPI | - | NPPES |
| 7016608 | Other | PA | AETNA PROVIDER NUMBER |
| 0001788000 | Other | PA | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 125090 (Pennsylvania) | Primary |
| 323P00000X | Psychiatric Residential Treatment Facility | (* (Not Available)) | Secondary |
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