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: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16367 RYNEARSON RD
BUCHANAN MI
49107-9470
US
IV. Provider business mailing address
16367 RYNEARSON RD
BUCHANAN MI
49107-9470
US
V. Phone/Fax
- Phone: 269-224-0977
- Fax: 269-224-0978
- Phone: 269-224-0977
- Fax: 269-224-0978
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROWAN
KELLEY
Title or Position: OWNER
Credential: MS, LPC, LMHC
Phone: 269-224-0977