Healthcare Provider Details
I. General information
NPI: 1487866109
Provider Name (Legal Business Name): CAROLYN LUNA-ANDERSON LPCC, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2325 CERRILLOS RD
SANTA FE NM
87505-3373
US
IV. Provider business mailing address
PO BOX 4939
SANTA FE NM
87502-4939
US
V. Phone/Fax
- Phone: 505-438-0010
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 0087401 |
| License Number State | NM |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | R12868 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: