MRS. AMBER J ILLUM LPC
NPI 1497886378
Counselor - Professional in Suwanee, GA

Active since March 09, 2007Opted out of Medicare · through Jan 9, 2028
3455 LAWRENCEVILLE SUWANEE RD STE A, SUWANEE, GA 30024(770) 932-2899(770) 932-2895 Get Directions Write a Review

NPPES record last updated: January 28, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mrs. Amber J Illum Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. AMBER J ILLUM LPC (NPI 1497886378) is an individual professional provider in Suwanee, Georgia, licensed in Georgia (LPC004396) and active in the NPI registry since March 2007. She has opted out of Medicare through January 9, 2028.

NPPES Registry Identity

NPI1497886378
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameMRS. AMBER J ILLUMCredential: LPC
Location Address3455 LAWRENCEVILLE SUWANEE RD STE ASuwanee, GA 30024-6425
Mailing Address3455 Lawrenceville Suwanee Rd Ste ASuwanee, GA 30024-6425 · (770) 932-2899 · Fax (770) 932-2895
Fax(770) 932-2895
Sole ProprietorNo
Enumeration DateMarch 9, 2007
Last NPPES UpdateJanuary 28, 2013
NPI 1497886378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in GA · LPC004396
3455 LAWRENCEVILLE SUWANEE RD STE A, Suwanee, GA 30024

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Mrs. Amber J Illum Lpc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 9, 2024 through January 9, 2028.

Opt-Out Effective DateJanuary 9, 2024
Opt-Out In Effect ThroughJanuary 9, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024
Counselor (Mental Health)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024
Counselor (Professional)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024
Counselor (Professional)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024
Counselor (Mental Health)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024
Counselor (Professional)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024
Counselor (Professional)
3455 LAWRENCEVILLE SUWANEE RD STE A
SUWANEE, GA 30024

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 Amber Illum's NPI number?

The NPI number for Amber Illum is 1497886378. It was assigned to this individual provider in the NPPES registry on March 9, 2007.

Where is Amber Illum located?

Amber Illum practices at 3455 Lawrenceville Suwanee Rd Ste A, Suwanee, GA 30024. The listed phone number is (770) 932-2899.

What is Amber Illum's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Amber Illum enrolled in Medicare?

No. Amber Illum has opted out of Medicare through January 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Amber Illum was last updated on January 28, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.