| Illuminate Life Therapy, Llc | |
|
1605 N Ankeny Blvd Ste 110 Ankeny IA 50023-4163 | |
| (515) 520-8164 | |
| Not Available |
| Full Name | Illuminate Life Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1605 N Ankeny Blvd Ste 110, Ankeny, Iowa |
| Authorized Official Name and Position | Carolyn Hollister (OWNER) |
| Authorized Official Contact | 5155208164 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illuminate Life Therapy, Llc 1605 N Ankeny Blvd Ste 110 Ankeny IA 50023-4163 Ph: () - | Illuminate Life Therapy, Llc 1605 N Ankeny Blvd Ste 110 Ankeny IA 50023-4163 Ph: (515) 520-8164 |
| NPI Number | 1194408500 |
|---|---|
| Provider Enumeration Date | 08/11/2023 |
| Last Update Date | 08/16/2023 |
| Certification Date | 08/16/2023 |
| Medicare PECOS PAC ID | 9638525686 |
|---|---|
| Medicare Enrollment ID | O20231026002391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194408500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carolyn Hollister |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932778610 PECOS PAC ID: 2365898319 Enrollment ID: I20231026002447 |
Ankeny Family Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Sw Plaza Shops Ln Ste D, Ankeny, IA 50023 Phone: 515-508-1150 Fax: 866-473-0770 | |
Thoroughways Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1207 Se Village View Ln, Ankeny, IA 50021 Phone: 641-521-6688 | |
Achieve Tms Centers Central Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1517 N Ankeny Blvd Ste F, Ankeny, IA 50023 Phone: 413-341-2401 Fax: 413-341-5954 | |
Wr Jacobs Enterprises, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 Ne Lowell Dr, Ankeny, IA 50021 Phone: 515-509-0219 | |
Birchwood Wellness Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 6950 Ne 14th St Ste 36, Ankeny, IA 50023 Phone: 515-289-1515 Fax: 515-289-1511 | |
Holistic Connections Family Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1605 N Ankeny Blvd Ste 110, Ankeny, IA 50023 Phone: 515-446-9516 | |
Lori Eisbrener, Lmhc, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2525 N Ankeny Blvd, Ste 113, Ankeny, IA 50021 Phone: 515-289-9136 |