MEDICARE: LUNA JURD LPC-ASSOCIATE

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	101YP2500X	Professional Counselor	95349	TX

General Provider Information

NPI Number	:	1578306437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUNA JURD LPC-ASSOCIATE

Provider Business Mailing Address
First Line	:	PO BOX 121835
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-7835
Country	:	US
Telephone Number	:	855-579-5323
Fax Number	:	855-579-5323

Provider Business Practice Location Address
First Line	:	101 E RANDOL MILL RD STE 100
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5800
Country	:	US
Telephone Number	:	855-579-5323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2024
Last Update Date	:	06/17/2024

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Directions to “ LUNA JURD LPC-ASSOCIATE” Practice Location

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