Provider Demographics
NPI:1841556438
Name:LUNA, LILIA (MA)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 CENTRAL PARK DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8813
Mailing Address - Country:US
Mailing Address - Phone:970-879-1632
Mailing Address - Fax:
Practice Address - Street 1:940 CENTRAL PARK DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8813
Practice Address - Country:US
Practice Address - Phone:970-879-1632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-08
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CO0004292103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor