Organization
LIGHTHOUSE COUNSELING CENTER AND ASSOCIATED THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHESTER MICHAEL MARTIN MA,MS,M ED, D. MIN (ADMINISTRATOR)
(910) 323-3368
Entity
Organization
Contact information
Practice address
901 ARSENAL AVE STE 202, FAYETTEVILLE, NC 28305-5478
(910) 323-3368
(910) 486-7000
Mailing address
901 ARSENAL AVE, SUITE 202, FAYETTEVILLE, NC 28305-5398
(910) 323-3368
(910) 486-7000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6008209
—
NC
05
—
8301795
—
NC
Enumeration date
04/16/2009
Last updated
12/08/2022
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