Healthcare Provider Details

I. General information

NPI: 1346187606
Provider Name (Legal Business Name): LUMA MENTAL HEALTH AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 PEARL PARK WAY FL 11
CHARLOTTE NC
28204-0076
US

IV. Provider business mailing address

443 BURR ST
INDIAN TRAIL NC
28079-0709
US

V. Phone/Fax

Practice location:
  • Phone: 704-964-6930
  • Fax:
Mailing address:
  • Phone: 704-964-6930
  • Fax: 704-519-2606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JAIME ALLISON SNYDER
Title or Position: CNP
Credential: APRN
Phone: 704-964-6930