Organization
ILLUMINATION PSYCHOTHERAPY SERVICES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN FERNANDES (OWNER)
(508) 728-1149
Entity
Organization
Contact information
Practice address
4 WYNDHAM RD, LAKEVILLE, MA 02347-2264
(508) 728-1149
Mailing address
PO BOX 915, LAKEVILLE, MA 02347-0915
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/13/2018
Last updated
05/06/2026
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