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Organization

ILLUMINATION COUNSELING SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICOLE GROSS M.S., LPC, NCC (PRESIDENT)
(484) 402-4727
Entity
Organization

Contact information

Practice address
5 GREAT VALLEY PKWY STE 210, MALVERN, PA 19355-1426
(484) 402-4727
Mailing address
5 GREAT VALLEY PKWY STE 210, MALVERN, PA 19355-1426
(484) 402-4727

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
09/09/2019
Last updated
09/09/2019
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