Provider Demographics
NPI:1841090925
Name:LUMINOUS MIND FOUNDATION INCORPORATED
Entity type:Organization
Organization Name:LUMINOUS MIND FOUNDATION INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCSW, LADAC
Authorized Official - Phone:915-260-8113
Mailing Address - Street 1:2601 E YANDELL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-3743
Mailing Address - Country:US
Mailing Address - Phone:915-260-8113
Mailing Address - Fax:
Practice Address - Street 1:2601 E YANDELL DR STE 104
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3743
Practice Address - Country:US
Practice Address - Phone:915-260-8113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)