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General NPI Number Information
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NPI Number | 1184366791
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Entity Type | Organization
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Legal Business Name | LUMINARY COUNSELING, PLLC
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 6633 E HWY 290 STE 110
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City | AUSTIN
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State | TX
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Zip | 78723-1157
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Country | US
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Telephone | 512-657-7744
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Fax |
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Provider Business Mailing Address
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Address Line | 6633 E HWY 290 STE 110
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City | AUSTIN
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State | TX
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Zip | 78723-1157
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Country | US
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Telephone | 512-657-7744
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER WILLIAMS BUFFALO
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Credential | MA, LPC-S, LMFT
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Telephone | 512-466-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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