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General NPI Number Information
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NPI Number | 1932861523
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Entity Type | Organization
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Legal Business Name | ILUMINACION COUNSELING & WELLNESS
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 5511 PARKCREST DR STE 103
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City | AUSTIN
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State | TX
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Zip | 78731-4917
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Country | US
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Telephone | 480-686-1447
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Fax |
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Provider Business Mailing Address
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Address Line | 5511 PARKCREST DR STE 103
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City | AUSTIN
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State | TX
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Zip | 78731-4917
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Country | US
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Telephone | 480-686-1447
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL THERAPIST
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Name | MONICA A GARFIAS
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Credential | LPC
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Telephone | 480-686-1447
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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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