Provider Demographics
NPI:1922537984
Name:ILLUMINE COUNSELING
Entity Type:Organization
Organization Name:ILLUMINE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HONSBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:614-398-1505
Mailing Address - Street 1:1735 PARKGATE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2003
Mailing Address - Country:US
Mailing Address - Phone:614-398-1505
Mailing Address - Fax:614-340-2920
Practice Address - Street 1:6797 N HIGH ST STE 319
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2533
Practice Address - Country:US
Practice Address - Phone:614-398-1505
Practice Address - Fax:614-340-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-8471SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty