Illumination Counseling Services, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ILLUMINATION COUNSELING SERVICES, LLC

Practice address

5 Great Valley Pkwy Ste 210
Malvern, PA 19355-1426

Phone

(484) 402-4727

NPI assigned

Sep 9, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicole Gross, M.S., LPC, NCCNPI 1972999043

Title

President

Phone

(484) 402-4727

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Gross, NCC

  • Counselor
  • West Chester, PA
  • NPI 1972999043
  NPD Authorized official
• Jacqueline Lorraine Covatta, LPC

  • Professional Counselor
  • Phoenixville, PA
  • NPI 1316349400
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1013566454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GREAT VALLEY PKWY STE 210",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551426",
            "telephone_number": "484-402-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GREAT VALLEY PKWY STE 210",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551426",
            "telephone_number": "484-402-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATION COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "484-402-4727",
        "authorized_official_credential": "M.S., LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Malvern",
            "affiliation": "N",
            "address_1": "5 Great Valley Pkwy Ste 210",
            "city": "Malvern",
            "state": "PA",
            "country_code": "US",
            "postal_code": "193551426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David N Horwich, MD
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• Jonah Ingram
• Inner Illumination Therapy & Wellness, LLC

• Professional Counselor in Malvern, PA
• Providers in Malvern, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.