Organization
LIGHTHOUSE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID PRESTON MACKINNON PH.D. (PRESIDENT)
(630) 325-4770
Entity
Organization
Contact information
Practice address
244 E OGDEN AVE, SUITE 11, HINSDALE, IL 60521-3648
(630) 325-4770
Mailing address
244 E OGDEN AVE, SUITE 11, HINSDALE, IL 60521-3648
(630) 325-4770
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004301
IL
106H00000X
Marriage & Family Therapist
166000403
IL
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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