Organization
LIGHTHOUSE COUNSELING PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS S FREEMAN PSYD (OWNER PRESIDENT)
(770) 251-5873
Entity
Organization
Contact information
Practice address
121 JACKSON STREET, NEWNAN, GA 30263
(770) 251-5873
(770) 304-2201
Mailing address
121 JACKSON STREET, NEWNAN, GA 30263
(770) 251-5873
(770) 304-2201
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC002899
GA
101YP2500X
Professional Counselor
Primary
LPC003462
GA
103TC0700X
Clinical Psychologist
PSY001469
GA
103TC0700X
Clinical Psychologist
PSY002042
GA
103TC0700X
Clinical Psychologist
PSY002610
GA
103TC0700X
Clinical Psychologist
PSY002820
GA
103TC0700X
Clinical Psychologist
PSY002947
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00458818D
—
GA
05
—
00727658C
—
GA
05
—
00964598A
—
GA
Enumeration date
02/22/2007
Last updated
07/24/2007
Update your record
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