Provider Demographics
NPI:1699474148
Name:GUIDING LIGHT THERAPY CENTER LLC
Entity type:Organization
Organization Name:GUIDING LIGHT THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHALONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-694-2744
Mailing Address - Street 1:8743 OAKCREST DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-5557
Mailing Address - Country:US
Mailing Address - Phone:317-694-2744
Mailing Address - Fax:
Practice Address - Street 1:2555 55TH PL STE 202
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3550
Practice Address - Country:US
Practice Address - Phone:317-694-2744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty