Healthcare Provider Details
I. General information
NPI: 1811756299
Provider Name (Legal Business Name): LUMINAPATH COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2024
Last Update Date: 01/05/2025
Certification Date: 01/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
454 PERRY HWY
PITTSBURGH PA
15229-1819
US
IV. Provider business mailing address
1518 BROADWAY AVE
MC KEES ROCKS PA
15136-1704
US
V. Phone/Fax
- Phone: 724-217-4227
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAIGE
MALNOFSKY
Title or Position: PROFESSIONAL COUNSELOR
Credential: MS, LPC, NCC
Phone: 724-217-4227