Provider Demographics
NPI:1427458207
Name:INNER LIGHT COUNSELING LLC
Entity type:Organization
Organization Name:INNER LIGHT COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMHC
Authorized Official - Phone:321-594-7633
Mailing Address - Street 1:8857 LAKE FLORENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-8931
Mailing Address - Country:US
Mailing Address - Phone:321-594-7633
Mailing Address - Fax:407-696-4831
Practice Address - Street 1:650 MAITLAND AVE
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6862
Practice Address - Country:US
Practice Address - Phone:321-594-7633
Practice Address - Fax:407-696-4831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty