| Luminous Psychiatry And Therapeutic Services Llc | |
|
7805 Waters Ave # 7a-4 Savannah GA 31406-2441 | |
| (888) 462-1601 | |
| Not Available |
| Full Name | Luminous Psychiatry And Therapeutic Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7805 Waters Ave # 7a-4, Savannah, Georgia |
| Authorized Official Name and Position | Jeannine Nicole Frazier (OWNER) |
| Authorized Official Contact | 9124846459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminous Psychiatry And Therapeutic Services Llc 7805 Waters Ave # 7a-4 Savannah GA 31406-2441 Ph: (888) 462-1601 | Luminous Psychiatry And Therapeutic Services Llc 7805 Waters Ave # 7a-4 Savannah GA 31406-2441 Ph: (888) 462-1601 |
| NPI Number | 1003594698 |
|---|---|
| Provider Enumeration Date | 07/05/2023 |
| Last Update Date | 07/05/2023 |
| Certification Date | 07/05/2023 |
| Medicare PECOS PAC ID | 6204280571 |
|---|---|
| Medicare Enrollment ID | O20230921000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003594698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jeannine Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467961623 PECOS PAC ID: 9739448465 Enrollment ID: I20180125001284 |
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