Provider Demographics
NPI:1285144659
Name:LUNA, MICHELLE (MS, LMFT, LCDC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:LUNA
Suffix:
Gender:F
Credentials:MS, LMFT, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 N CAPITAL OF TEXAS HWY APT 1110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1176
Mailing Address - Country:US
Mailing Address - Phone:361-449-0868
Mailing Address - Fax:
Practice Address - Street 1:7700 N CAPITAL OF TEXAS HWY APT 1110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1176
Practice Address - Country:US
Practice Address - Phone:361-449-0868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14511101YA0400X
TX203087106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist