Provider Demographics
NPI:1861932923
Name:BEACON OF LIGHT FAMILY COUNSELING, PLLC
Entity type:Organization
Organization Name:BEACON OF LIGHT FAMILY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMFT
Authorized Official - Phone:509-406-3170
Mailing Address - Street 1:6 S 2ND ST STE 403
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-2629
Mailing Address - Country:US
Mailing Address - Phone:509-406-3170
Mailing Address - Fax:
Practice Address - Street 1:6 S 2ND ST STE 403
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2629
Practice Address - Country:US
Practice Address - Phone:509-406-3170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health