Healthcare Provider Details

I. General information

NPI: 1891652202
Provider Name (Legal Business Name): LUMINA PSYCHIATRY AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

31 WILLARD ST
WAREHAM MA
02571-1209
US

IV. Provider business mailing address

31 WILLARD ST
WAREHAM MA
02571-1209
US

V. Phone/Fax

Practice location:
  • Phone: 508-738-3387
  • Fax: 508-772-8776
Mailing address:
  • Phone: 508-738-3387
  • Fax: 508-772-8776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYNTHIA LOPES
Title or Position: CEO
Credential: DNP, PMHNP, AGPCNP
Phone: 508-738-3387