Provider Demographics
NPI:1225872088
Name:LIGHTWAY THERAPY LLC
Entity type:Organization
Organization Name:LIGHTWAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUZMINA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:404-844-3984
Mailing Address - Street 1:17 CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-3943
Mailing Address - Country:US
Mailing Address - Phone:404-844-3984
Mailing Address - Fax:
Practice Address - Street 1:17 CROSSING DR
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3943
Practice Address - Country:US
Practice Address - Phone:404-844-3984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty