ILLUME COUNSELING & PLAY THERAPY (NPI# 1508472648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508472648 |
| Entity Type | Organization |
| Organization Name | ILLUME COUNSELING & PLAY THERAPY |
| Practice Address |
35008 Emerald Coast Pkwy Ste 203 Destin FL 32541-4752 |
| Mailing Address |
416 Primrose Cir Destin FL 32541-2232 |
| Practice Telephone | 2512090680 |
| Mailing Telephone | 2512090680 |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | KELSEY LAINE SCHNEIDER (PRESIDENT) |
| Authorized Official Telephone | 2512090216 |
| Authorized Official Credential | M.ED., LMHC, RPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
35008 EMERALD COAST PKWY STE 203 |
| City | DESTIN |
| State | FL |
| Zip Code | 32541-4752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578020574 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | Sec of Hwy 98 and Gulf Shore Drive, Destin, FL 32541 | 2019-02-26 |
| 1932640471 | Kathryn Clower | Chiropractor | 36474c Emerald Coast Pkwy Ste 3101, Destin, FL 32541 | 2017-03-16 |
| 1881133148 | Danielle Mckinney | Physical Therapist | 35008 Emerald Coast Pkwy Ste 400, Destin, FL 32541 | 2017-02-20 |
| 1417304643 | Coastal Pediatric Group | Pediatrics | 36468 Emerald Coast Pkwy Unit 2101, Destin, FL 32541 | 2016-05-17 |
| 1336563956 | Blu By The Sea,llc | Clinic/Center | 3399 Scenic Highway 98, Destin, FL 32541 | 2014-02-18 |
| 1740539535 | Courtney Breaux Mcgee | Physician Assistant | 155 Crystal Beach Drive #121, Destin, FL 32541 | 2012-09-07 |
| 1073861704 | Nathan Hall Dmd Pl | Dentist | 4484 Legendary Dr, Suite B, Destin, FL 32541 | 2012-08-28 |
| 1982991121 | Bayshore Retreat, LLC | Substance Abuse Rehabilitation Facility | 457 Cahoun Ave, Destin, FL 32541 | 2011-07-08 |
| 1457661605 | Destin Surgery Clinic, P.a. | Specialist | 415 Mountain Drive, Suite # 6, Destin, FL 32541 | 2010-10-20 |
| 1194032581 | Laura Mathisen | Behavioral Analyst | 3820 Misty Way, Destin, FL 32541 | 2010-09-07 |
| Find all providers in zip 32541 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881233252 | Stephanie Aldridge Butler | Counselor | 457 Calhoun Ave, Destin, FL 32541-1508 | 2020-01-02 |
| 1407269665 | Mindi Lunday | Counselor | 428 Captains Cir, Destin, FL 32541-5304 | 2014-06-05 |
| 1689940306 | Melanie Alexander | Counselor | 120 Benning Dr Ste 1, Destin, FL 32541-2432 | 2012-03-27 |
| 1376795690 | Valerie P. Peterson | Counselor | 215 Mountain Dr #106, Emerald Coast Counseling Center, Pa, Destin, FL 32541 | 2008-10-17 |
| 1821132408 | Angela Lynn Matthews | Counselor | 3815 Indigo Cir, Destin, FL 32541-2022 | 2007-02-16 |
| 1629157342 | Radford H Mcgrath | Counselor | 3997 Commons Dr W Ste C, Destin, FL 32541-8444 | 2006-11-03 |
| 1275614703 | Anne Noles Sparks | Counselor | 303 Tegvesta Dr, Destin, FL 32541 | 2006-10-18 |
| 1538142096 | Linda G Buckland | Counselor | 215 Mountain Drive, Suite 106, Destin, FL 32541-2346 | 2005-11-29 |
| 1992708432 | Tonya K Freeman | Counselor | 4507 Furling Ln, Ste 208, Destin, FL 32541-5342 | 2005-05-28 |
| 1568951176 | Mary Kathleen Hensley | Counselor | 137 Crystal Beach Dr Ste 137-c, Destin, FL 32541-3569 | 2018-05-09 |
| Find all providers in DESTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.