Provider Demographics
NPI:1811375108
Name:ILLUMINATE CHRISTIAN COUNSELING, LLC
Entity Type:Organization
Organization Name:ILLUMINATE CHRISTIAN COUNSELING, LLC
Other - Org Name:BRITTANY COLEMAN, MA, LPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:210-845-7949
Mailing Address - Street 1:625 PECAN ROW
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-2130
Mailing Address - Country:US
Mailing Address - Phone:210-845-7949
Mailing Address - Fax:210-545-2504
Practice Address - Street 1:19115 FM 2252
Practice Address - Street 2:STE. 12
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2577
Practice Address - Country:US
Practice Address - Phone:210-845-7949
Practice Address - Fax:210-545-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty