Provider Demographics
NPI:1518791318
Name:GUIDING LIGHT BEHAVIOR HEALTH CENTER
Entity type:Organization
Organization Name:GUIDING LIGHT BEHAVIOR HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRIBLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCS
Authorized Official - Phone:910-374-7035
Mailing Address - Street 1:210 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-5620
Mailing Address - Country:US
Mailing Address - Phone:910-374-7035
Mailing Address - Fax:910-739-9954
Practice Address - Street 1:210 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5620
Practice Address - Country:US
Practice Address - Phone:910-374-7035
Practice Address - Fax:910-739-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty