Healthcare Provider Details

I. General information

NPI: 1932082401
Provider Name (Legal Business Name): LUMINOUS MINDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E 3RD ST
BUCHANAN MI
49107-1404
US

IV. Provider business mailing address

16367 RYNEARSON RD
BUCHANAN MI
49107-9470
US

V. Phone/Fax

Practice location:
  • Phone: 269-224-0977
  • Fax: 269-224-0978
Mailing address:
  • Phone: 269-224-0977
  • Fax: 269-224-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ROWAN KELLEY
Title or Position: OWNER
Credential:
Phone: 269-224-0977