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General NPI Number Information
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NPI Number | 1356938591
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Entity Type | Organization
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Legal Business Name | LUNA MENTAL HEALTH CENTER LLC
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Dates
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Enumeration Date | 12/22/2020
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 2949 FEDERAL BLVD # 203
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City | DENVER
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State | CO
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Zip | 80211-3741
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Country | US
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Telephone | 720-277-6125
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Fax |
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Provider Business Mailing Address
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Address Line | 2580 BLUE HERON CIR W
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City | LAFAYETTE
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State | CO
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Zip | 80026-9141
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ THERAPIST
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Name | MRS. BROOKE VANEK
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Credential | MA, LPC
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Telephone | 720-277-6125
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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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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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