NPIMap

Organization Active NPI

Lighted Path Therapy Services

  • Professional Counselor
  • Wasilla, AK
National Provider Identifier
1093212466
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
809 Issued in AK
Legal business name
LIGHTED PATH THERAPY SERVICES
Practice address
901 N. Leatherleaf Loop Suite 103
Wasilla, AK 99654
Phone
(907) 312-1202
Fax
(855) 553-8083
NPI assigned
Apr 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bradford Eric Holl, LPCNPI 1306277702
Title
Owner
Phone
(907) 312-1202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 809 AK Primary

Addresses

Primary practice location

901 N. Leatherleaf Loop Suite 103
Wasilla, AK 99654

Mailing address

PO Box 871336
Wasilla, AK 99654
Phone (907) 312-1202

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1093212466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871336",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-312-1202",
            "fax_number": "855-553-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N. LEATHERLEAF LOOP SUITE 103",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-312-1202",
            "fax_number": "855-553-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTED PATH THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "HOLL",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-312-1202",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.