Provider Demographics
NPI:1154504710
Name:LUMIERE, KEILI ADIYAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEILI
Middle Name:ADIYAH
Last Name:LUMIERE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KEILIA
Other - Middle Name:ADIYAH
Other - Last Name:LUMIERE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:103 E VAN BUREN
Mailing Address - Street 2:SUITE 149
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-3653
Mailing Address - Country:US
Mailing Address - Phone:206-618-6960
Mailing Address - Fax:
Practice Address - Street 1:103 E VAN BUREN
Practice Address - Street 2:SUITE 149
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-3653
Practice Address - Country:US
Practice Address - Phone:509-388-5768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X, 1744R1102X, 174H00000X, 171M00000X, 175F00000X, 174400000X, 174H00000X
TX174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No1744R1102XOther Service ProvidersSpecialistResearch Study
No174H00000XOther Service ProvidersHealth Educator
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175F00000XOther Service ProvidersNaturopath