Healthcare Provider Details

I. General information

NPI: 1578417259
Provider Name (Legal Business Name): LUMINESS PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1867 W 1700 S
SYRACUSE UT
84075-9144
US

IV. Provider business mailing address

3166 S 1075 W
SYRACUSE UT
84075-9097
US

V. Phone/Fax

Practice location:
  • Phone: 801-856-1659
  • Fax:
Mailing address:
  • Phone: 801-856-1659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN SAXEY
Title or Position: OWNER/PRACTITIONER
Credential: PA-C
Phone: 801-971-1985