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General NPI Number Information
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NPI Number | 1356200042
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Entity Type | Organization
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Legal Business Name | ILLUMINATE PLAY THERAPY & COUNSELING
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 111 E 3RD ST STE 206
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City | RIFLE
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State | CO
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Zip | 81650-2346
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Country | US
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Telephone | 970-316-5009
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Fax | 970-316-5891
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Provider Business Mailing Address
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Address Line | 185 REMINGTON ST
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City | RIFLE
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State | CO
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Zip | 81650-9628
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Country | US
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Telephone | 970-316-5009
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Fax | 970-316-5891
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Authorized Official
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Title or Position | OWNER
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Name | NATALIE WILLEY HANKS
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Credential |
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Telephone | 970-316-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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