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Organization
HEALING LIGHT
Active
Organization
HEALING LIGHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KANA NOOTENBOOM LICENSED MFT (CLINICAL DIRECTOR)
(949) 419-5491
Entity
Organization
Contact information
Practice address
2637 W HORIZON RIDGE PKWY STE 100, HENDERSON, NV 89052-4835
(702) 716-0908
(702) 550-4774
Mailing address
2637 W HORIZON RIDGE PKWY STE 100, HENDERSON, NV 89052-4835
(702) 716-0908
(702) 550-4774
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
NULL
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
NULL
101YS0200X
School Counselor
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
NULL
106E00000X
Assistant Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
133N00000X
Nutritionist
—
NULL
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
12/08/2020
Last updated
12/21/2020
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