Organization
LIGHTHOUSE COUNSELING SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL LONG MA (THERAPIST/OWNER)
(314) 403-2113
Entity
Organization
Contact information
Practice address
9890 CLAYTON RD STE 100, SAINT LOUIS, MO 63124-1685
(314) 403-2113
(618) 310-3893
Mailing address
9890 CLAYTON RD STE 100, SAINT LOUIS, MO 63124-1685
(314) 403-2113
(618) 310-3893
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2004003782
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130927125309555
—
MO
Enumeration date
03/06/2014
Last updated
03/06/2014
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