NPIMap

Organization Active NPI

Light Heart Counseling and Therapy Services, LLC

  • Social Worker
  • Erie, PA
National Provider Identifier
1306113659
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW125058 Issued in PA
Legal business name
LIGHT HEART COUNSELING AND THERAPY SERVICES, LLC
Practice address
4845 W Lake Rd
Suite 120
Erie, PA 16505-2973
Phone
(814) 528-5323
Fax
(814) 725-0707
NPI assigned
Nov 30, 2011
Last updated
Nov 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Edward Thiry III, LSW
Title
Owner
Phone
(814) 528-5323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X SW125058 PA Primary

Addresses

Primary practice location

4845 W Lake Rd
Suite 120
Erie, PA 16505-2973

Mailing address

4845 W Lake Rd
Suite 120
Erie, PA 16505-2973
Phone (814) 528-5323

National Provider Directory

National Provider Directory

Locations

4845 W Lake Rd
#120
Erie, PA 16505
Phone (814) 528-5323

4845 W Lake Rd
Ste 120
Erie, PA 16505
Phone (814) 528-5323

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1306113659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 W LAKE RD",
            "address_2": "SUITE 120",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052973",
            "telephone_number": "814-528-5323",
            "fax_number": "814-725-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 W LAKE RD",
            "address_2": "SUITE 120",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165052973",
            "telephone_number": "814-528-5323",
            "fax_number": "814-725-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT HEART COUNSELING AND THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "THIRY III",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-528-5323",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW125058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.