Illuminate – Psychologist, NPI 1336301894

Psychologist

Illuminate is a healthcare provider. based in Lake elmo, Minnesota. specializing in Psychologist. The organization holds a License No. LP-1196 (MN). The NPI Number for Illuminate is 1336301894

Main info

Organization

Name

Illuminate

NPI

1336301894

Phone

(651) 264-0444

Address

8615 EAGLE POINT BLVD

Authorized Official

MS. SHARON BLOSSOM PRESIDENT

Enumeration Date

26 June 2008

Last Update Date

26 June 2008

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience48

Completeness80

Years active:17State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Illuminate

Eagle Point Boulevard, Lake Elmo, Washington County, Minnesota, 55125, United States
LAKE ELMO, MN 550428628
Phone: (651) 264-0444
Fax: (651) 264-0447
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55042)

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Reviews

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Frequently asked questions

What number should I use to identify Illuminate for billing?

Administrative and clinical systems typically use NPI 1336301894 for Illuminate.

Is Illuminate's NPI status active today?

Active status means Illuminate's NPI record is not deactivated in the public file.

How should patients interpret Illuminate's specialty?

The extract shows Psychologist for Illuminate. Clinical services aligned with this taxonomy classification.

Is Illuminate tied to Lake Elmo, Minnesota?

If you are local to Lake Elmo, Minnesota, Illuminate may be relevant to your search.

What is the difference between NPI and a medical license?

An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.