Provider Demographics
NPI:1942084819
Name:LUMA MARRIAGE AND FAMILY THERAPY, PLLC
Entity Type:Organization
Organization Name:LUMA MARRIAGE AND FAMILY THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARSHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:609-741-1145
Mailing Address - Street 1:1885 HYLAN BLVD # 1032
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2110
Mailing Address - Country:US
Mailing Address - Phone:609-741-1145
Mailing Address - Fax:
Practice Address - Street 1:1 EDGEWATER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:609-741-1145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty