Provider Demographics
NPI:1710733571
Name:LUMEN HEALTHCARE PARTNERS, LLC
Entity type:Organization
Organization Name:LUMEN HEALTHCARE PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/SLP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADELA
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:DART
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:757-513-4808
Mailing Address - Street 1:2673 JETSTREAM RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2499
Mailing Address - Country:US
Mailing Address - Phone:757-513-4808
Mailing Address - Fax:
Practice Address - Street 1:2673 JETSTREAM RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2499
Practice Address - Country:US
Practice Address - Phone:757-513-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty