Provider Demographics
NPI:1831869650
Name:HEALING LIGHT COUNSELING AND INTEGRATIVE SERVICES, LLC
Entity type:Organization
Organization Name:HEALING LIGHT COUNSELING AND INTEGRATIVE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLOCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:717-496-5729
Mailing Address - Street 1:2133 MARKET ST STE 220
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4718
Mailing Address - Country:US
Mailing Address - Phone:717-496-5729
Mailing Address - Fax:
Practice Address - Street 1:2133 MARKET ST STE 220
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4718
Practice Address - Country:US
Practice Address - Phone:717-496-5729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty