Healthcare Provider Details

I. General information

NPI: 1518896687
Provider Name (Legal Business Name): LUMA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 S LEGEND HILLS DR STE 339
CLEARFIELD UT
84015-1592
US

IV. Provider business mailing address

1463 JUNE DR
FARMINGTON UT
84025-2828
US

V. Phone/Fax

Practice location:
  • Phone: 801-898-8879
  • Fax:
Mailing address:
  • Phone: 801-898-8879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHAYA ANDERSON
Title or Position: CLINICAL MENTAL HEALTH COUNSELOR
Credential: CMHC
Phone: 801-898-8879