Organization
ILLUME PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACIA THIEL LCSW (FOUNDER/THERAPIST)
(973) 206-0282
Entity
Organization
Contact information
Practice address
8 HILLSIDE AVE STE 202, MONTCLAIR, NJ 07042-2129
(973) 206-0282
Mailing address
41 WATCHUNG PLZ # 176, MONTCLAIR, NJ 07042-4117
(973) 206-0282
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/17/2021
Last updated
03/03/2026
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