Healthcare Provider Details
I. General information
NPI: 1437942943
Provider Name (Legal Business Name): LUMINA MENTAL WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
74 EASTERN PROMENADE ST
HOLYOKE MA
01040-2906
US
IV. Provider business mailing address
74 EASTERN PROMENADE ST
HOLYOKE MA
01040-2906
US
V. Phone/Fax
- Phone: 413-314-0113
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SP0808X |
| Taxonomy | Psychiatric/Mental Health Clinical Nurse Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DENNIES
JONES-BROWN
Title or Position: OWNER
Credential:
Phone: 413-314-0113