Illuminate Life Therapy, Llc - Medicare Mental Health Clinic in Ankeny, IA

Illuminate Life Therapy, Llc is a medicare enrolled mental health clinic (Social Worker - Clinical) in Ankeny, Iowa. The current practice location for Illuminate Life Therapy, Llc is 1605 N Ankeny Blvd Ste 110, Ankeny, Iowa. For appointments, you can reach them via phone at (515) 520-8164. The mailing address for Illuminate Life Therapy, Llc is 1605 N Ankeny Blvd Ste 110, Ankeny, Iowa and phone number is () -.

Illuminate Life Therapy, Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1194408500. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (515) 520-8164.

Contact Information

Illuminate Life Therapy, Llc
1605 N Ankeny Blvd Ste 110
Ankeny
IA 50023-4163
(515) 520-8164
Not Available

Mental Health Clinic Profile

Full NameIlluminate Life Therapy, Llc
SpecialitySocial Worker
Location1605 N Ankeny Blvd Ste 110, Ankeny, Iowa
Authorized Official Name and PositionCarolyn Hollister (OWNER)
Authorized Official Contact5155208164
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Illuminate Life Therapy, Llc
1605 N Ankeny Blvd Ste 110
Ankeny
IA 50023-4163

Ph: () -
Illuminate Life Therapy, Llc
1605 N Ankeny Blvd Ste 110
Ankeny
IA 50023-4163

Ph: (515) 520-8164

NPI Details:

NPI Number1194408500
Provider Enumeration Date08/11/2023
Last Update Date08/16/2023
Certification Date08/16/2023

Medicare PECOS Information:

Medicare PECOS PAC ID9638525686
Medicare Enrollment IDO20231026002391

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Medical Identifiers

Medical identifiers for Illuminate Life Therapy, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194408500NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Illuminate Life Therapy, Llc acts as a billing entity for following providers:
Provider NameCarolyn Hollister
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1932778610
PECOS PAC ID: 2365898319
Enrollment ID: I20231026002447

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