Healthcare Provider Details

I. General information

NPI: 1710818018
Provider Name (Legal Business Name): LUMINA INTEGRATIVE PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 BAY POINTE DR
HIXSON TN
37343-6106
US

IV. Provider business mailing address

2023 BAY POINTE DR
HIXSON TN
37343-6106
US

V. Phone/Fax

Practice location:
  • Phone: 413-297-2717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: AMANDA SCOLA
Title or Position: OWNER
Credential:
Phone: 413-297-2717