Provider Demographics
NPI:1417776972
Name:LIGHTWELL COUNSELING, PLLC
Entity type:Organization
Organization Name:LIGHTWELL COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HAASE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:909-831-6182
Mailing Address - Street 1:86 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-2708
Mailing Address - Country:US
Mailing Address - Phone:909-831-6182
Mailing Address - Fax:
Practice Address - Street 1:86 HOPE ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-2708
Practice Address - Country:US
Practice Address - Phone:909-831-6182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty