MEDICARE: LUMA MENTAL HEALTH AND WELLNESS, PLLC

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	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1346187606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMA MENTAL HEALTH AND WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	443 BURR ST
Second Line	:
City	:	INDIAN TRAIL
State	:	NC
Zip	:	28079-0709
Country	:	US
Telephone Number	:	704-964-6930
Fax Number	:	704-519-2606

Provider Business Practice Location Address
First Line	:	1000 PEARL PARK WAY FL 11
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-0076
Country	:	US
Telephone Number	:	704-964-6930
Fax Number	:

Authorized Official
Title or Position	:	CNP
Name	:	JAIME ALLISON SNYDER
Credential	:	APRN
Telephone Number	:	704-964-6930

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	06/17/2026

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