Illuminate Life Wellness LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

ILLUMINATE LIFE WELLNESS LLC

Practice address

126 Pawtuxet Ter
West Warwick, RI 02893-5212

Phone

(401) 542-9080

NPI assigned

Mar 4, 2021

Organization subpart

No

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

Authorized official

Name

Katherine KinsellaNPI 1649678178

Title

Manager

Phone

(401) 542-9080

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katherine Kinsella, ED.D, LMFT, LMHC

  • Marriage & Family Therapist
  • Warwick, RI
  • NPI 1649678178
  NPD Authorized official

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1114512829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 PAWTUXET TER",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PAWTUXET TER",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028935212",
            "telephone_number": "401-542-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE LIFE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "KINSELLA",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-542-9080"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holding Hope Counseling LLC
• Emily J Horcha, DMD
• Alexandra Hunt, LICSW
• Robert Wilson Huxtable, L.M.H.C., L.C.D.P.
• Robert Raymond Iacono, COTA/L
• Shamaila Imam
• Angela Jacavone, DO
• Alice Jacob
• Richard Francis Jardon, DC
• Rebecca Lynn Johnson, MA,LMHC MHC 01482

• Adult Mental Health Clinic/Center in West Warwick, RI
• Providers in West Warwick, RI by specialty
• Adult Mental Health Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.