Healthcare Provider Details

I. General information

NPI: 1972465573
Provider Name (Legal Business Name): LUMINATHERA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 HARRISON AVE STE 200
COLUMBUS OH
43215-1300
US

IV. Provider business mailing address

929 HARRISON AVE STE 200
COLUMBUS OH
43215-1300
US

V. Phone/Fax

Practice location:
  • Phone: 614-982-0262
  • Fax:
Mailing address:
  • Phone: 614-982-0262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAY KARR
Title or Position: CO-OWNER
Credential: LPCC-S
Phone: 614-614-9820