Organization
LIGHTHOUSE COUNSELING AND MENTAL HEALHT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PERCY W FORD JR. LPC-MSHP,NCC (CEO/OWNER)
(615) 692-4935
Entity
Organization
Contact information
Practice address
310 UPTOWN SQ, MURFREESBORO, TN 37129-0574
(615) 692-4935
(855) 261-6356
Mailing address
5165 BROOKSTONE CT, ANTIOCH, TN 37013-5687
(615) 692-4935
(855) 261-6356
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
I000000010821
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528221
—
TN
Enumeration date
07/19/2012
Last updated
07/19/2012
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