Provider Demographics
NPI:1477123917
Name:LA LUNA COUNSELING AND WELLNESS INC
Entity Type:Organization
Organization Name:LA LUNA COUNSELING AND WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, ACS
Authorized Official - Phone:732-943-6791
Mailing Address - Street 1:29 STONEY CREEK LN
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1657
Mailing Address - Country:US
Mailing Address - Phone:732-943-6791
Mailing Address - Fax:
Practice Address - Street 1:29 STONEY CREEK LN
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1657
Practice Address - Country:US
Practice Address - Phone:732-943-6791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)