Healthcare Provider Details

I. General information

NPI: 1558272864
Provider Name (Legal Business Name): LUMINARY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 3RD ST NW STE A
FORT PAYNE AL
35967-2101
US

IV. Provider business mailing address

PO BOX 680271
FORT PAYNE AL
35968-1617
US

V. Phone/Fax

Practice location:
  • Phone: 256-304-5712
  • Fax:
Mailing address:
  • Phone: 205-382-0932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAURA LEONARD ROBERTS
Title or Position: ASSOCIATE LICENSED COUNSELOR/OWNER
Credential: MS, ALC, NCC
Phone: 205-382-0932