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General NPI Number Information
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NPI Number | 1922537984
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Entity Type | Organization
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Legal Business Name | ILLUMINE COUNSELING
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 6797 N HIGH ST STE 319
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City | WORTHINGTON
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State | OH
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Zip | 43085-2533
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Country | US
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Telephone | 614-398-1505
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Fax | 614-340-2920
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Provider Business Mailing Address
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Address Line | 1735 PARKGATE RD
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City | COLUMBUS
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State | OH
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Zip | 43229-2003
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Country | US
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Telephone | 614-398-1505
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Fax | 614-340-2920
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Authorized Official
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Title or Position | OWNER
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Name | AMY HONSBERGER
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Credential | LISW
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Telephone | 614-398-1505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I-8471SUPV
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License Number State | OH
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