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General NPI Number Information
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NPI Number | 1457015521
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Entity Type | Organization
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Legal Business Name | LUMEN ESSENCE, LLC
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 1324 N LINWOOD AVE
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City | BALTIMORE
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State | MD
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Zip | 21213
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Country | US
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Telephone | 443-502-0773
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Fax |
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Provider Business Mailing Address
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Address Line | 9613C HARFORD RD UNIT 140
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City | BALTIMORE
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State | MD
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Zip | 21234-2103
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Country | US
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Telephone | 443-502-0773
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LATINA MARIE HOWARD
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Credential | LCSW-C
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Telephone | 443-801-2130
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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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