Provider Demographics
NPI:1265024376
Name:LUMINARY COUNSELING
Entity Type:Organization
Organization Name:LUMINARY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MULROY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-254-8703
Mailing Address - Street 1:80 APPLE BLOSSOM WAY
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1388
Mailing Address - Country:US
Mailing Address - Phone:508-254-8703
Mailing Address - Fax:
Practice Address - Street 1:80 APPLE BLOSSOM WAY
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:MA
Practice Address - Zip Code:01775-1388
Practice Address - Country:US
Practice Address - Phone:508-254-8703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health