Illumination Psychotherapy Services, LLC.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ILLUMINATION PSYCHOTHERAPY SERVICES, LLC.

Practice address

4 Wyndham Rd
Lakeville, MA 02347-2264

Phone

(508) 728-1149

NPI assigned

Feb 13, 2018

Organization subpart

No

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

Authorized official

Name

Kathryn FernandesNPI 1831549807

Title

Owner

Phone

(508) 728-1149

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Practitioners 1

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

• Kathryn Fernandes, LMHC

  • Mental Health Counselor
  • Lakeville, MA
  • NPI 1831549807

  MA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1609376987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 915",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023470915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WYNDHAM RD",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023472264",
            "telephone_number": "508-728-1149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUMINATION PSYCHOTHERAPY SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-13",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "FERNANDES",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-728-1149"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Lynn Hebert, BCBA, LABA
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• Danielle Horton, B.S. ORT
• Frannie Hsu
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• Rhiannon Jackson, LMHC
• Ginny Lynn Kelly, LICSW
• Ghassan A Khoury, DMD,MPH,PC

• All providers in Lakeville, MA
• Community/Behavioral Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.