Provider Demographics
NPI:1447819867
Name:LIVING IN THE LIGHT WELLNESS
Entity type:Organization
Organization Name:LIVING IN THE LIGHT WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCURRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-641-1221
Mailing Address - Street 1:24285 KATY FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1128
Mailing Address - Country:US
Mailing Address - Phone:832-641-1221
Mailing Address - Fax:832-218-1979
Practice Address - Street 1:88 N AVONDALE RD # 352
Practice Address - Street 2:
Practice Address - City:AVONDALE ESTATES
Practice Address - State:GA
Practice Address - Zip Code:30002-1323
Practice Address - Country:US
Practice Address - Phone:470-588-5570
Practice Address - Fax:832-218-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)