Organization Active NPI

Light and Glory

  • Mental Health Counselor
  • Puyallup, WA
National Provider Identifier
1639048242
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LIGHT AND GLORY
Practice address
102 23Rd Ave SE Ste a
Puyallup, WA 98372-4501
Phone
(253) 234-7185
Fax
(253) 987-7223
NPI assigned
Nov 3, 2025
Last updated
Nov 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Jessica Tate, MA, LMFTNPI 1972937894
Title
Co-Founder/Ceo
Phone
(808) 237-9320

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
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

102 23Rd Ave SE Ste a
Puyallup, WA 98372-4501

Mailing address

102 23Rd Ave SE Ste a
Puyallup, WA 98372-4501
Phone (253) 234-7185

National Provider Directory

National Provider Directory

Locations

102 23rd Ave SE
Ste A
Puyallup, WA 98372
Phone (253) 446-0311

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1639048242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 23RD AVE SE STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724501",
            "telephone_number": "253-234-7185",
            "fax_number": "253-987-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 23RD AVE SE STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724501",
            "telephone_number": "253-234-7185",
            "fax_number": "253-987-7223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT AND GLORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-02",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CO-FOUNDER/CEO",
        "authorized_official_telephone_number": "808-237-9320",
        "authorized_official_credential": "MA, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.