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Illumine Counseling Lcsw PLLC

Social Worker, Clinical in New York, NY. Organization (NPI-2).

NPI number1639875511
StatusActive
Last updated in NPPESMar 7, 2023

Details

NPI
1639875511
Entity type
Organization (NPI-2)
Legal business name
Illumine Counseling Lcsw PLLC
Organization subpart
No
Enumeration date
Feb 2, 2023
Certification date
Mar 7, 2023
Last updated
Mar 7, 2023

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical––Yes

Practice location

131 7th Ave # 356
New York, NY 10011-1802

Phone 646-470-1231

Mailing address

131 7th Ave # 356
New York, NY 10011-1802

Phone 646-470-1231

Other practice locations

725 Riverside Dr Apt 4c
New York, NY 10031-2460

Phone 646-470-1231

Authorized official

Tashi Ridley
Partner
2122879357

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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