MEDICARE: ILLUMINATING INSIGHTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1306785480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLUMINATING INSIGHTS

Provider Business Mailing Address
First Line	:	2321 RIVERSIDE DR STE 42
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-4267
Country	:	US
Telephone Number	:	844-933-2484
Fax Number	:	434-354-2204

Provider Business Practice Location Address
First Line	:	2321 RIVERSIDE DR STE 42
Second Line	:
City	:	DANVILLE
State	:	VA
Zip	:	24540-4267
Country	:	US
Telephone Number	:	844-933-2484
Fax Number	:	434-354-2204

Authorized Official
Title or Position	:	OWNER
Name	:	SHERROD FISHER
Credential	:	LPC
Telephone Number	:	844-933-2484

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	05/27/2026

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