Provider Demographics
NPI:1003679465
Name:LUZ ANIMA PSYCHOTHERAPY & ALTERNATIVE HEALING LLC
Entity Type:Organization
Organization Name:LUZ ANIMA PSYCHOTHERAPY & ALTERNATIVE HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PINERA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:915-667-0130
Mailing Address - Street 1:371 BIG HORN RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-1424
Mailing Address - Country:US
Mailing Address - Phone:915-667-0130
Mailing Address - Fax:
Practice Address - Street 1:371 BIG HORN RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-1424
Practice Address - Country:US
Practice Address - Phone:915-667-0130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health