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Organization
LIGHT AND LIFE THERAPY LLC
Active
Organization
LIGHT AND LIFE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN DIAMANTIS LCSW, MDIV, CSOTP (OWNER)
(757) 559-1690
Entity
Organization
Contact information
Practice address
6350 CENTER DR STE 106, NORFOLK, VA 23502-4107
(757) 559-1690
(757) 767-7921
Mailing address
3049 CLARKE DR, VIRGINIA BEACH, VA 23456-7923
(757) 559-1690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316466410
—
VA
05
—
1760198022
—
VA
Enumeration date
02/16/2023
Last updated
04/01/2025
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