MEDICARE: ILLUMINATED INSIGHTS COUNSELING 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1093588055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLUMINATED INSIGHTS COUNSELING LLC

Provider Business Mailing Address
First Line	:	1145 OLD WESTMINSTER PIKE
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-7014
Country	:	US
Telephone Number	:	410-861-0167
Fax Number	:

Provider Business Practice Location Address
First Line	:	1145 OLD WESTMINSTER PIKE
Second Line	:
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-7014
Country	:	US
Telephone Number	:	410-861-0167
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	ANGELA KECK
Credential	:	LCPC
Telephone Number	:	410-861-0167

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	01/28/2026

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