Provider Demographics
NPI:1861052797
Name:BE THE LIGHT LLC
Entity type:Organization
Organization Name:BE THE LIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER OF BE THE LIGHT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW-LCSW
Authorized Official - Phone:201-394-5028
Mailing Address - Street 1:202 BLOOMFIELD AVE APT 309
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5790
Mailing Address - Country:US
Mailing Address - Phone:973-572-8103
Mailing Address - Fax:
Practice Address - Street 1:202 BLOOMFIELD AVE APT 309
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-5790
Practice Address - Country:US
Practice Address - Phone:973-572-8103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty