Provider Demographics
NPI:1780363465
Name:ILLUMINATING PERSPECTIVES COUNSELING & CONSULTATION, LLC
Entity type:Organization
Organization Name:ILLUMINATING PERSPECTIVES COUNSELING & CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMYE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:716-480-4152
Mailing Address - Street 1:2035 HOGBACK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9488
Mailing Address - Country:US
Mailing Address - Phone:734-252-6258
Mailing Address - Fax:
Practice Address - Street 1:13377 LAKE POINT BLVD
Practice Address - Street 2:
Practice Address - City:VAN BUREN TWP
Practice Address - State:MI
Practice Address - Zip Code:48111-2288
Practice Address - Country:US
Practice Address - Phone:716-480-4152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty