Organization
LIGHTHOUSE COUNSELING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE JUDETH COSTELLO ATHERTON-ELY L.P.C. (OWNER)
(570) 562-1166
Entity
Organization
Contact information
Practice address
812 S MAIN ST, TAYLOR, PA 18517-1828
(570) 562-1166
(570) 457-3779
Mailing address
812 S MAIN ST, P.O. BOX 35, TAYLOR, PA 18517-1828
(570) 562-1166
(570) 457-3779
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
357033
PA
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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