ILLUMINATE PSYCHOTHERAPY PLLC
NPI 1417568890
Psychologist - Clinical in Chattanooga, TN
About Illuminate Psychotherapy Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ILLUMINATE PSYCHOTHERAPY PLLC (NPI 1417568890) is a healthcare organization registered as a clinical in Chattanooga, Tennessee and active in the NPI registry since August 2020. The organization lists Judy Gilliam, Administrative Expert, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Illuminate Psychotherapy Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Illuminate Psychotherapy PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Illuminate Psychotherapy PLLC's NPI number?
The NPI number for Illuminate Psychotherapy PLLC is 1417568890. It was assigned to this organization in the NPPES registry on August 11, 2020.
Where is Illuminate Psychotherapy PLLC located?
Illuminate Psychotherapy PLLC is located at 101 Jordan Dr, Chattanooga, TN 37421. The listed phone number is (423) 510-1999.
What is Illuminate Psychotherapy PLLC's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Illuminate Psychotherapy PLLC enrolled in Medicare?
Yes. Illuminate Psychotherapy PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Illuminate Psychotherapy PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Illuminate Psychotherapy PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Illuminate Psychotherapy PLLC was last updated on August 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Illuminate Psychotherapy Pllc · NPI 1417568890
Clinical organization in Chattanooga, Tennessee. Organization record, active in the CMS NPPES registry since August 11, 2020.
## Identity
- **NPI:** 1417568890 (Entity type: Organization)
- **Enumerated:** August 11, 2020
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **Organization subpart:** No
- **Authorized official:** Judy Gilliam, ADMINISTRATIVE EXPERT
## Practice location
- **Address:** 101 JORDAN DR, Chattanooga, TN 37421-6732
- **Phone:** (423) 510-1999
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 11, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1417568890) · Data from the CMS NPPES public registry.