Provider Demographics
NPI:1821846957
Name:LUMINOUS THERAPY AND WELLNESS
Entity type:Organization
Organization Name:LUMINOUS THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:910-264-5215
Mailing Address - Street 1:10970 LITTLE FIVE LOOP
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-8063
Mailing Address - Country:US
Mailing Address - Phone:910-264-5215
Mailing Address - Fax:
Practice Address - Street 1:2520 PROFESSIONAL RD STE E
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3267
Practice Address - Country:US
Practice Address - Phone:804-220-0071
Practice Address - Fax:804-843-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty