NPIMap

Organization Active NPI

Illuminate Counseling & Wellness LLC

  • Social Worker
  • Newaygo, MI
National Provider Identifier
1306376439
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
ILLUMINATE COUNSELING & WELLNESS LLC
Practice address
42 State Rd Ste a
Newaygo, MI 49337-7989
Phone
(231) 942-4673
NPI assigned
Jun 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Authorized official

Name
Jennifer Braman, LLMSW
Title
Social Worker
Phone
(231) 942-4673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

42 State Rd Ste a
Newaygo, MI 49337-7989

Mailing address

42 State Rd Ste a
Newaygo, MI 49337-7989
Phone (231) 942-4673

Other identifiers 1

IdentifierTypeStateIssuer
1669801684MedicaidMI

National Provider Directory

National Provider Directory

Locations

42 W State Rd
Ste A
Newaygo, MI 49337
Phone (231) 206-6519

NPI Registry JSON

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1306376439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 STATE RD STE A",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493377989",
            "telephone_number": "231-942-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 STATE RD STE A",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493377989",
            "telephone_number": "231-942-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATE COUNSELING & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-12",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "BRAMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "231-942-4673",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669801684",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newaygo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.