Provider Demographics
NPI:1215308929
Name:LUNA, ALBERTO DANIEL (PHD, BSS, NCSP)
Entity type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:DANIEL
Last Name:LUNA
Suffix:
Gender:M
Credentials:PHD, BSS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2166 BRONX PARK E
Mailing Address - Street 2:APT 6D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1212
Mailing Address - Country:US
Mailing Address - Phone:917-699-6588
Mailing Address - Fax:
Practice Address - Street 1:1115 ELKTON DR STE 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3597
Practice Address - Country:US
Practice Address - Phone:719-357-6471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009121103TC2200X, 103TC0700X
NY2557050103TS0200X
NY103T00000X
COPSY.0004937103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical