Organization
ILLUMINATE LIFE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE KINSELLA ED.D, LMFT, LMHC (MANAGER)
(843) 696-6221
Entity
Organization
Contact information
Practice address
2220 PLAINFIELD PIKE, CRANSTON, RI 02921-2031
(401) 889-3788
(401) 223-6506
Mailing address
126 PAWTUXET TER, WEST WARWICK, RI 02893-5212
(843) 696-6221
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
MHC00885
RI
106H00000X
Marriage & Family Therapist
4649
SC
106H00000X
Marriage & Family Therapist
Primary
MFT00179
RI
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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