=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285572990
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUMINA BEHAVIORAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2026
-----------------------------------------------------
Last Update Date | 03/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 354 MERRIMACK ST STE 275
-----------------------------------------------------
City | LAWRENCE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01843-1755
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-250-5908
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 LEWIS ST
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01610-1779
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-250-5908
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | CATHERINE NGANGA
-----------------------------------------------------
Credential | PMHNP
-----------------------------------------------------
Telephone | 508-250-5908
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------