MEDICARE: ILLUMINATION PSYCHOTHERAPY SERVICES, LLC.

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1609376987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLUMINATION PSYCHOTHERAPY SERVICES, LLC.

Provider Business Mailing Address
First Line	:	PO BOX 915
Second Line	:
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-0915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 WYNDHAM RD
Second Line	:
City	:	LAKEVILLE
State	:	MA
Zip	:	02347-2264
Country	:	US
Telephone Number	:	508-728-1149
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHRYN FERNANDES
Credential	:
Telephone Number	:	508-728-1149

Provider Enumeration Date	:	02/13/2018
Last Update Date	:	05/06/2026

Similar Medicare Providers

1881407880 — HSA KARE INC.
Practice Location Address:

17912 ENIGMA WAY
LAKEVILLE, MN
55044-2264

Practice Phone: 612-581-4992
Practice Fax:

1861323701 — JENNIFER ROCHA
Practice Location Address:

6 TIMOTHY RD
LAKEVILLE, MA
02347-1854

Practice Phone: 781-624-3530
Practice Fax:

1225637770 — MRS. MICHELLE SUESANN ARANCIO PMHNP
Practice Location Address:

109 RHODE ISLAND RD
LAKEVILLE, MA
02347-1370

Practice Phone: 508-299-5468
Practice Fax: 508-983-8345

1750245726 — TRUE NORTH PSYCHIATRY INC
Practice Location Address:

109 RHODE ISLAND RD STE 1
LAKEVILLE, MA
02347-1370

Practice Phone: 508-299-5468
Practice Fax: 508-983-8345

1831549807 — MS. KATHRYN FERNANDES LMHC
Practice Location Address:

PO BOX 915
LAKEVILLE, MA
02347-0915

Practice Phone: 508-728-1149
Practice Fax:

1679566798 — CAROLINA GAPUD MD
Practice Location Address:

2 LAKEVILLE BUSINESS PARK
LAKEVILLE, MA
02347-1236

Practice Phone: 508-947-0630
Practice Fax: 508-947-0639

Directions to “ILLUMINATION PSYCHOTHERAPY SERVICES, LLC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.