Provider Demographics
NPI:1699585083
Name:LUXE TMS & WELLNESS PLLC
Entity type:Organization
Organization Name:LUXE TMS & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TENIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROTTER
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:252-676-0475
Mailing Address - Street 1:8401 MAYLAND DR STE S
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4648
Mailing Address - Country:US
Mailing Address - Phone:252-676-0475
Mailing Address - Fax:
Practice Address - Street 1:8401 MAYLAND DR STE S
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4648
Practice Address - Country:US
Practice Address - Phone:252-676-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1053781005OtherNURSE PRACTITIONER