Provider Demographics
NPI:1104621424
Name:LUMA COUNSELING
Entity type:Organization
Organization Name:LUMA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:JR
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-855-4776
Mailing Address - Street 1:315 BARNETTE ST UNIT 74915
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-1157
Mailing Address - Country:US
Mailing Address - Phone:401-855-4773
Mailing Address - Fax:
Practice Address - Street 1:3939 OLD WOOD ROAD
Practice Address - Street 2:SUITE 74915
Practice Address - City:ESTER
Practice Address - State:AK
Practice Address - Zip Code:99709
Practice Address - Country:US
Practice Address - Phone:401-855-4776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty