Illume Psychotherapy LLC
NPI #1285219576 in Bloomfield, New Jersey
Provider Information
- NPI Number
- 1285219576
- Entity Type
- Organization
- Organization Name
- Illume Psychotherapy LLC
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Mar 17, 2021
- Last Updated
- Mar 17, 2021
Practice Location
- Address
- 440 FRANKLIN ST STE 200
- City
- Bloomfield
- State
- New Jersey
- ZIP Code
- 07003-4379
- Phone
- (973) 206-0282
Authorized Official
- Name
- MS. STACIA THIEL, LCSW
- Title
- FOUNDER/THERAPIST
- Phone
- (973) 206-0282
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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