| Illumination Psychotherapy Services, Llc. | |
|
4 Wyndham Rd Lakeville MA 02347-2264 | |
| (508) 317-4927 | |
| Not Available |
| Full Name | Illumination Psychotherapy Services, Llc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4 Wyndham Rd, Lakeville, Massachusetts |
| Authorized Official Name and Position | Kathryn Fernandes (OWNER) |
| Authorized Official Contact | 5083174927 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illumination Psychotherapy Services, Llc. Po Box 915 Lakeville MA 02347-0915 Ph: () - | Illumination Psychotherapy Services, Llc. 4 Wyndham Rd Lakeville MA 02347-2264 Ph: (508) 317-4927 |
| NPI Number | 1609376987 |
|---|---|
| Provider Enumeration Date | 02/13/2018 |
| Last Update Date | 01/31/2025 |
| Certification Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609376987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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