Provider Demographics
NPI:1457015521
Name:LUMEN ESSENCE, LLC
Entity Type:Organization
Organization Name:LUMEN ESSENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-801-2130
Mailing Address - Street 1:9613C HARFORD RD UNIT 140
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2103
Mailing Address - Country:US
Mailing Address - Phone:443-502-0773
Mailing Address - Fax:
Practice Address - Street 1:1324 N LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213
Practice Address - Country:US
Practice Address - Phone:443-502-0773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty