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General NPI Number Information
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NPI Number | 1811892862
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Entity Type | Organization
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Legal Business Name | LUMEN BEHAVIORAL LLC
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Dates
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Enumeration Date | 10/10/2026
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Last Update Date | 10/10/2026
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Provider Practice Location Address
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Address Line | 1301 CHATTAHOOCHEE AVE NW APT 313
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City | ATLANTA
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State | GA
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Zip | 30318-3222
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Country | US
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Telephone | 404-618-3425
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Fax |
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Provider Business Mailing Address
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Address Line | 8735 DUNWOODY PL STE 8331
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-2995
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Country | US
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Telephone | 404-618-3425
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MIKAYLA ROANE
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Credential |
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Telephone | 404-618-3425
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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 | NULL
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