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Organization
ILLUMINATE THERAPY CENTER
Active
Organization
ILLUMINATE THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY LUNDY LCSW (OWNER)
(567) 242-9371
Entity
Organization
Contact information
Practice address
839 MAJESTIC CT STE 6, GASTONIA, NC 28054-5152
(704) 386-6747
(704) 997-1711
Mailing address
839 MAJESTIC CT STE 6, GASTONIA, NC 28054-5152
(704) 386-6747
(704) 997-1711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/04/2023
Last updated
08/04/2023
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