Organization
ILLUMINATE SUPERVISION AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALECIA ANN SMITH LISW (OWNER)
(515) 639-0676
Entity
Organization
Contact information
Practice address
400 5TH ST, LAKE VIEW, IA 51450-7725
(515) 639-0676
(515) 639-0676
Mailing address
PO BOX 136, LAKE VIEW, IA 51450-0136
(515) 639-0676
(515) 639-0676
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
11/05/2025
Last updated
11/05/2025
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