Organization
GUIDING LIGHT FAMILY COUNSELING
Active
Organization
GUIDING LIGHT FAMILY COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER TAVELLA MA LPC LCAS CS-I NCC (DIRECTOR/OWNER/COUNSELOR)
(704) 880-4003
Entity
Organization
Contact information
Practice address
18135 W CATAWBA AVE, SUITE 6, CORNELIUS, NC 28031-5641
(704) 880-4003
(704) 880-4003
Mailing address
18135 W CATAWBA AVE, SUITE 6, CORNELIUS, NC 28031-5641
(704) 880-4003
(704) 880-4003
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1682
NC
101YP2500X
Professional Counselor
Primary
7986
NC
Other
Enumeration date
08/28/2011
Last updated
02/01/2012
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