MEDICARE: LUMOS PSYCHIATRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist

General Provider Information

NPI Number	:	1306779855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMOS PSYCHIATRY LLC

Provider Business Mailing Address
First Line	:	1166 E WARNER RD STE 113
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-3065
Country	:	US
Telephone Number	:	480-277-2231
Fax Number	:	480-378-3537

Provider Business Practice Location Address
First Line	:	1166 E WARNER RD STE 113
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-3065
Country	:	US
Telephone Number	:	480-277-2231
Fax Number	:	480-378-3537

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	ELISA CSADER
Credential	:	MN
Telephone Number	:	480-277-2231

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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