Provider Demographics
NPI:1992108849
Name:LAMPLIGHT COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:LAMPLIGHT COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:S
Authorized Official - Last Name:RICHARD
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:303-331-5800
Mailing Address - Street 1:PO BOX 360823
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-0014
Mailing Address - Country:US
Mailing Address - Phone:330-331-5800
Mailing Address - Fax:330-331-5805
Practice Address - Street 1:4015 MEDINA RD STE 90
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-5970
Practice Address - Country:US
Practice Address - Phone:330-331-5800
Practice Address - Fax:330-331-5805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI. 0800217-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1003927187Medicare UPIN