ILLUMINATION PSYCHOLOGY PLLC (NPI# 1699384495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699384495 |
| Entity Type | Organization |
| Organization Name | ILLUMINATION PSYCHOLOGY PLLC |
| Practice Address |
88 Terry Rd Ste 106 Smithtown NY 11787-3811 |
| Practice Telephone | 6312097564 |
| Mailing Telephone | 6312097564 |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2020-07-28 |
| Authorized Official Name | MICHAEL INFRANCO (OWNER) |
| Authorized Official Telephone | 6316819157 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | ILLUMINATION PSYCHOLOGY PLLC | 88 Terry Rd, Ste 106, Smithtown, New York 11787 |
| Street Address |
88 TERRY RD STE 106 |
| City | SMITHTOWN |
| State | NY |
| Zip Code | 11787-3811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558962779 | Gwendolyn Burris | Counselor | 20 Gilbert Avenue, Suite 107-a, Smithtown, NY 11787 | 2020-11-04 |
| 1467051193 | Karin M Caro | Adult Companion | 9 Three Pond Road, Smithtown, NY 11787 | 2020-10-23 |
| 1639706641 | Nimit Khara | Student in an Organized Health Care Education/Training Program | 240 Middle Country Rd A, Smithtown, NY 11787 | 2020-03-27 |
| 1003469032 | Maria Teresa Gardella | Nurse Practitioner | St. Catherine of Siena Medical Center, 50 Ny-25a, Smithtown, NY 11787 | 2019-07-18 |
| 1558922070 | Pamella Ann Grillo | Physician Assistant | 373 Ny-111 #5, Smithtown, NY 11787 | 2019-06-25 |
| 1306308127 | Sherry Hansen | Social Worker | 285 Middle Country Rd, Suite Ll5, Smithtown, NY 11787 | 2019-04-01 |
| 1932663747 | Kayla Roundsman | Counselor | 11 Route 11, Smithtown, NY 11787 | 2019-01-25 |
| 1568959856 | Moreen Johnson | Registered Nurse | Christian Nursing Registry, 17 Bank Ave, Smith Town, NY 11787 | 2018-04-23 |
| 1992217871 | Erica Zeller Licensed Clinical Social Work Pllc | Social Worker | 15 Bellemeade Ave Ste 3, Smithtown, NY 11787 | 2017-10-31 |
| 1881117802 | Oisin Vincent Keenan | Case Manager/Care Coordinator | 11 Ny-111, Smithtown, NY 11787 | 2017-07-21 |
| Find all providers in zip 11787 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484151 | Fred Ronald Waxenberg | Psychologist | 3001 Hewlett Ave, Merrick, NY 11566-5312 | 2020-10-16 |
| 1528672870 | Alexandra E Lamm | Psychologist | 50 W 96th Street, Apt 5a-d, New York, NY 10025 | 2020-09-03 |
| 1881212140 | Elizabeth Wilen-berg | Psychologist | 308 W 103rd St Apt 8d, New York, NY 10025-4463 | 2020-07-13 |
| 1396361747 | Jeanna Pagnotta | Psychologist | 109 N 12th St Ste 507, Brooklyn, NY 11249-1002 | 2020-06-22 |
| 1376167544 | Amelio A D'onofrio | Psychologist | 58 E 79th St Fl 4f, New York, NY 10075-0221 | 2020-06-03 |
| 1114540648 | Alexandra Lerner | Psychologist | 10 Whitetail Dr, Ithaca, NY 14850-9458 | 2020-05-19 |
| 1386265882 | Abba Human Services Foundation, Inc | Psychologist | 10 Schriever Ln Ste B, New City, NY 10956-3314 | 2020-05-06 |
| 1750911160 | Julie Herman Hirschfeld | Psychologist | 575 West End Ave. Gr-a-3, New York, NY 10024-2711 | 2020-01-24 |
| 1588204093 | Rebecca Frances Reed | Psychologist | 1 City Pl Apt 610, White Plains, NY 10601-3334 | 2020-01-13 |
| 1750928735 | Gregory Alexander, Ph.d. Psychologist, PC | Psychologist | 260 W Main St Ste 9, Bay Shore, NY 11706-8322 | 2019-12-09 |
| Find all providers with the same taxonomy | ||||
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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.