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General NPI Number Information
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NPI Number | 1104621424
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Entity Type | Organization
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Legal Business Name | LUMA COUNSELING
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 3939 OLD WOOD ROAD SUITE 74915
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City | ESTER
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State | AK
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Zip | 99709
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Country | US
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Telephone | 401-855-4776
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Fax |
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Provider Business Mailing Address
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Address Line | 315 BARNETTE ST UNIT 74915
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City | FAIRBANKS
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State | AK
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Zip | 99707-1157
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Country | US
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Telephone | 401-855-4773
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Fax |
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Authorized Official
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Title or Position | OWNER / CEO
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Name | MR. PAUL L GAINES JR.
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Credential | L.I.C.S.W.
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Telephone | 401-855-4776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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