Healthcare Provider Details

I. General information

NPI: 1215308929
Provider Name (Legal Business Name): ALBERTO DANIEL LUNA PHD, BSS, NCSP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S WILCOX ST STE 104
CASTLE ROCK CO
80104-1957
US

IV. Provider business mailing address

2166 BRONX PARK E APT 6D
BRONX NY
10462-1200
US

V. Phone/Fax

Practice location:
  • Phone: 719-322-8175
  • Fax: 719-284-3771
Mailing address:
  • Phone: 917-699-6588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number2557050
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.009121
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number071.009121
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY.0004937
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: