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Organization
INTO THE LIGHT COUNSELING, INC.
Active
Organization
INTO THE LIGHT COUNSELING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA EAVES LCSW (OWNER/THERAPIST)
(919) 271-0135
Entity
Organization
Contact information
Practice address
353 W 2ND ST, CLAYTON, NC 27520-2336
(919) 271-0135
(888) 503-6822
Mailing address
PO BOX 1348, PO BOX 1348, CLAYTON, NC 27528-1348
(919) 271-0135
(888) 503-6822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004198
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141C3
BCBS
—
01
—
2860031A
MEDICARE
—
05
—
6003393
—
NC
Enumeration date
10/02/2012
Last updated
10/02/2012
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