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General NPI Number Information
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NPI Number | 1790391373
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Entity Type | Organization
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Legal Business Name | LUMINARY SOLUTIONS, PLLC
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Dates
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Enumeration Date | 09/19/2020
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 3166 N LINCOLN AVE STE 305
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City | CHICAGO
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State | IL
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Zip | 60657-3119
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Country | US
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Telephone | 847-920-8811
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 W GRACE ST APT 421
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City | CHICAGO
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State | IL
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Zip | 60613-6089
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Country | US
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Telephone | 312-813-4024
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND CLINICAL COUNSELOR
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Name | DR. MATTHEW LIBERATORE
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Credential | E.D., LCPC
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Telephone | 847-920-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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