| The Lighted Path Pllc | |
|
350 N Court St Suite 204-b Lapeer MI 48446-2263 | |
| (810) 692-1641 | |
| Not Available |
| Full Name | The Lighted Path Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 350 N Court St, Lapeer, Michigan |
| Authorized Official Name and Position | Christine Mccullough (SOLE MEMBER) |
| Authorized Official Contact | 8104230342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lighted Path Pllc 2670 Biscayne Ct Lapeer MI 48446-3293 Ph: (810) 423-0342 | The Lighted Path Pllc 350 N Court St Suite 204-b Lapeer MI 48446-2263 Ph: (810) 692-1641 |
| NPI Number | 1306559703 |
|---|---|
| Provider Enumeration Date | 12/30/2022 |
| Last Update Date | 07/03/2023 |
| Certification Date | 07/03/2023 |
| Medicare PECOS PAC ID | 3577934587 |
|---|---|
| Medicare Enrollment ID | O20230130000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306559703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christine Mccullough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881126506 PECOS PAC ID: 4880065408 Enrollment ID: I20230118002714 |
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