| Lunamind, Llc | |
|
2704 Hodges St Lake Charles LA 70601-7366 | |
| (337) 476-6410 | |
| Not Available |
| Full Name | Lunamind, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2704 Hodges St, Lake Charles, Louisiana |
| Authorized Official Name and Position | Christy Murphy (SOLE MEMBER) |
| Authorized Official Contact | 3374423474 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lunamind, Llc 849 Isabella St Sulphur LA 70663-1833 Ph: () - | Lunamind, Llc 2704 Hodges St Lake Charles LA 70601-7366 Ph: (337) 476-6410 |
| NPI Number | 1053160739 |
|---|---|
| Provider Enumeration Date | 05/15/2024 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Medicare PECOS PAC ID | 2163964016 |
|---|---|
| Medicare Enrollment ID | O20240606001158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053160739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Christy Vanessa Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952185100 PECOS PAC ID: 1658728704 Enrollment ID: I20231110000472 |
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