Provider Demographics
NPI:1932861523
Name:ILUMINACION COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:ILUMINACION COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARFIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-686-1447
Mailing Address - Street 1:5511 PARKCREST DR STE 103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4917
Mailing Address - Country:US
Mailing Address - Phone:480-686-1447
Mailing Address - Fax:
Practice Address - Street 1:5511 PARKCREST DR STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4917
Practice Address - Country:US
Practice Address - Phone:480-686-1447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty