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Organization
SOUTHERN LIGHT COMMUNITY COUNSELING
Active
Organization
SOUTHERN LIGHT COMMUNITY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY DRAKE (ADMINISTRATIVE DIRECTOR)
(417) 850-4555
Entity
Organization
Contact information
Practice address
1901 WOMMACK AVE, BOLIVAR, MO 65613-3128
(417) 850-4555
(417) 777-7017
Mailing address
707 S PEARL AVE, JOPLIN, MO 64801-4334
(417) 850-4555
(417) 777-7017
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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