Organization
BEACON OF LIGHT COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATEASA LINETTE MOORE LMSW (LICENSED CLINICAL SOCIAL WORKER)
(231) 515-2055
Entity
Organization
Contact information
Practice address
1515 E LAKETON AVE, MUSKEGON, MI 49442
(231) 515-2055
Mailing address
PO BOX 1264, MUSKEGON, MI 49443-1264
(231) 515-2055
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
11/24/2019
Last updated
11/24/2019
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