Illuminate Psychotherapy PLLC
NPI 1417568890ActiveOrganization· Psychologist, Clinical· Chattanooga, TN
Psychologist, Clinical in Chattanooga, Tennessee, registered in NPPES in August 2020. The authorized official on file is Judy Gilliam, Administrative Expert. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1417568890 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 11, 2020 |
| Last updated in NPPES | Aug 11, 2020 |
| Certified by provider | Aug 11, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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