Organization
BRIGHT LIGHT COUNSELING, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA WIEBEN LISW, RPT-S (OWNER)
(515) 992-6355
Entity
Organization
Contact information
Practice address
6165 NW 86TH ST # 127, JOHNSTON, IA 50131-2270
(515) 992-6355
Mailing address
6165 NW 86TH ST # 127, JOHNSTON, IA 50131-2270
(515) 992-6355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215220223
INDIVIDUAL NPI
—
Enumeration date
05/17/2020
Last updated
05/17/2020
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