Organization
LIGHTRISE FAMILY CHRISTIAN COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MADISON BERESFORD M.A. (PRESIDENT/LEAD PASTORAL COUNSELOR)
(224) 286-4673
Entity
Organization
Contact information
Practice address
265 EXCHANGE DR, 101B, CRYSTAL LAKE, IL 60014-6230
(224) 286-4673
Mailing address
265 EXCHANGE DR, 101B, CRYSTAL LAKE, IL 60014-6230
(224) 286-4673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/10/2013
Last updated
02/08/2016
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