Provider Demographics
NPI:1306730957
Name:SNOWLIGHT COUNSELING, LLC
Entity type:Organization
Organization Name:SNOWLIGHT COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-233-1631
Mailing Address - Street 1:249 IVERSON WAY
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8352
Mailing Address - Country:US
Mailing Address - Phone:937-661-4419
Mailing Address - Fax:
Practice Address - Street 1:22 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2110
Practice Address - Country:US
Practice Address - Phone:614-233-1631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI.2506562OtherLICENSED INDEPENDENT SOCIAL WORKER