Provider Demographics
NPI:1346961919
Name:ILLUMINATE COUNSELING LLC
Entity Type:Organization
Organization Name:ILLUMINATE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:HALLIE
Authorized Official - Last Name:CECIL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CADC
Authorized Official - Phone:515-305-2380
Mailing Address - Street 1:3408 WOODLAND AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6506
Mailing Address - Country:US
Mailing Address - Phone:515-305-2380
Mailing Address - Fax:515-517-6114
Practice Address - Street 1:3408 WOODLAND AVE STE 209
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6506
Practice Address - Country:US
Practice Address - Phone:515-305-2380
Practice Address - Fax:515-517-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health