Provider Demographics
NPI:1477176170
Name:LUMOS COUNSELING, PLLC
Entity Type:Organization
Organization Name:LUMOS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUENING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:920-562-7428
Mailing Address - Street 1:PO BOX 613
Mailing Address - Street 2:
Mailing Address - City:CHANNAHON
Mailing Address - State:IL
Mailing Address - Zip Code:60410-0613
Mailing Address - Country:US
Mailing Address - Phone:815-521-1889
Mailing Address - Fax:815-201-8228
Practice Address - Street 1:25 E WASHINGTON ST STE 1820
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1831
Practice Address - Country:US
Practice Address - Phone:920-562-7428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty