Provider Demographics
NPI:1285273094
Name:LIGHTHOUSE COUNSELING AND INTERVENTION LLC
Entity type:Organization
Organization Name:LIGHTHOUSE COUNSELING AND INTERVENTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCONIERI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LADC
Authorized Official - Phone:203-228-2606
Mailing Address - Street 1:3 TWIN OAK FARM RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-5338
Mailing Address - Country:US
Mailing Address - Phone:203-228-2606
Mailing Address - Fax:
Practice Address - Street 1:605 WASHINGTON AVE
Practice Address - Street 2:2ND FLOOR NORTH WING
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473
Practice Address - Country:US
Practice Address - Phone:203-228-2606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty