Healthcare Provider Details

I. General information

NPI: 1871429019
Provider Name (Legal Business Name): LUMORA MINDFULNESS & CONSULTING PLL C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 N CECIL RD STE 202
POST FALLS ID
83854-8966
US

IV. Provider business mailing address

9169 W STATE ST STE 3125
GARDEN CITY ID
83714-1733
US

V. Phone/Fax

Practice location:
  • Phone: 208-216-3351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LISA CALDER
Title or Position: AUTHORIZED ADMIN
Credential:
Phone: 208-216-3351