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General NPI Number Information
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NPI Number | 1003474024
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Entity Type | Organization
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Legal Business Name | LUNA COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 8720 GEORGIA AVE STE 205
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City | SILVER SPRING
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State | MD
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Zip | 20910-3614
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Country | US
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Telephone | 301-679-6033
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Fax | 888-552-0363
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Provider Business Mailing Address
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Address Line | 8720 GEORGIA AVE STE 205
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City | SILVER SPRING
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State | MD
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Zip | 20910-3614
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Country | US
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Telephone | 301-679-6033
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Fax | 888-552-0363
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MS. LEIDY MAGDALENA MENA
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Credential | LCMFT
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Telephone | 301-679-6033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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