Healthcare Provider Details

I. General information

NPI: 1306779855
Provider Name (Legal Business Name): LUMOS PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1166 E WARNER RD STE 113
GILBERT AZ
85296-3065
US

IV. Provider business mailing address

1166 E WARNER RD STE 113
GILBERT AZ
85296-3065
US

V. Phone/Fax

Practice location:
  • Phone: 480-277-2231
  • Fax: 480-378-3537
Mailing address:
  • Phone: 480-662-1176
  • Fax: 480-378-3537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ELISA CSADER
Title or Position: OWNER/PROVIDER
Credential: NP
Phone: 480-662-1176