First Light Counseling Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

7294-123 Issued in WI

Legal business name

FIRST LIGHT COUNSELING SERVICES LLC

Practice address

W6385 Firelane 8
Menasha, WI 54952-9746

Phone

(920) 739-9230

NPI assigned

Mar 26, 2015

Last updated

Mar 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurel Howard-Boardman, MSSW,LCSWNPI 1639191018

Title

Member

Phone

(920) 739-9230

Specialties & licenses 1

Addresses

Other names 1

• Laurel Howard-Boardman Other name

Locations

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.

• Laurel Howard-Boardman, MSSW, LCSW

  • Clinical Social Worker
  • Menasha, WI
  • NPI 1639191018
  Authorized official Same address or phone

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

{
    "created_epoch": "1427328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1962896068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6385 FIRELANE 8",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549529746",
            "telephone_number": "920-739-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W6385 FIRELANE 8",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549529746",
            "telephone_number": "920-739-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST LIGHT COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-26",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "HOWARD-BOARDMAN",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "920-739-9230",
        "authorized_official_credential": "MSSW,LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "7294-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurel Howard-Boardman",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Barbara Farb, NP
• Allison M Fassett, MD
• Becky L Fawley, SAC
• Julie A Feider, MSE, LPC
• Matthew J Feldbruegge, APNP
• Brandon Lee Franzke, MS, LPC
• Deann K. Froland, RMT
• Sharon Ann Froseth, BCABA
• Michael G. Frost, RADCI
• Joshua David Gandolf, CSAC

• Community/Behavioral Health Agency in Menasha, WI
• Providers in Menasha, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.