Organization Active NPI

Lumina Mind and Wellness Inc

  • Psychiatry Physician
  • Goodyear, AZ
National Provider Identifier
1053294017
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LUMINA MIND AND WELLNESS INC
Practice address
14441 W McDowell Rd Ste B102
Goodyear, AZ 85395-2519
Phone
(602) 763-8652
NPI assigned
Jul 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laura M Ross, PMHNP-BCNPI 1538417142
Title
Ceo
Phone
(602) 763-8652

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

14441 W McDowell Rd Ste B102
Goodyear, AZ 85395-2519

Mailing address

20044 N 68TH Dr
Glendale, AZ 85308-5594
Phone (602) 763-8652

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1053294017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20044 N 68TH DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085594",
            "telephone_number": "602-763-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14441 W MCDOWELL RD STE B102",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952519",
            "telephone_number": "602-763-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINA MIND AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-763-8652",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.