ILLUMINATE NORTH CAROLINA NPI 1821844796

NPI Information

NPI: 1821844796
Provider Name: ILLUMINATE NORTH CAROLINA
Classification: Counselor - 101YA0400X
Specialization: Addiction (Substance Use Disorder)
Entity Type: Organization
Doing Business As: ILLUMINATE NC
CLIA Number: 34D2316885
Address: 100 S GARNETT ST UNIT 105
HENDERSON, NC
ZIP 27536
Phone: (919) 622-5532

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NPI Details

ILLUMINATE NORTH CAROLINA is an addiction (substance use disorder) counselor in Henderson, NC. ILLUMINATE NORTH CAROLINA NPI is 1821844796. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Illuminate Nc.

The provider's business location address is:

100 S GARNETT ST UNIT 105
HENDERSON, NC
ZIP 27536-642
Phone: (919) 622-5532

The provider's authorized official is Lindsey Humphreys .
The authorized official title is Executive Director and has the following contact phone number (919) 622-5532.

The CLIA number assigned to this NPI record is 34D2316885 - other - substance abuse intensive with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2024 and was last updated on 12/12/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

What is NPI?

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This page was last updated on: 11/21/2025

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