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General NPI Number Information
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NPI Number | 1144072729
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Entity Type | Organization
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Legal Business Name | LUMINSPIRE COUNSELING COLLECTIVE PLLC
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Dates
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Enumeration Date | 04/04/2024
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 1691 FORUM PL STE B
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-2336
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Country | US
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Telephone | 561-512-4279
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Fax |
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Provider Business Mailing Address
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Address Line | 126 TWISTED PINES XING
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City | DAHLONEGA
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State | GA
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Zip | 30533-5078
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Country | US
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Telephone | 561-512-4279
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMANDA MARIE CHILLEME
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Credential | LMHC
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Telephone | 561-512-4279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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