Provider Demographics
NPI:1376367607
Name:LUMINA COUNSELING LLC
Entity type:Organization
Organization Name:LUMINA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFEE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CCMHC
Authorized Official - Phone:912-633-9414
Mailing Address - Street 1:5805 GEORGIA HIGHWAY 21 S STE 204
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5511
Mailing Address - Country:US
Mailing Address - Phone:912-633-9414
Mailing Address - Fax:
Practice Address - Street 1:5805 GEORGIA HIGHWAY 21 S STE 204
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5511
Practice Address - Country:US
Practice Address - Phone:912-633-9414
Practice Address - Fax:912-812-0053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty