Organization Active NPI

Luminescence Counseling Inc

  • Clinical Social Worker
  • Stuart, FL
National Provider Identifier
1265967830
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13243 Issued in FL
Legal business name
LUMINESCENCE COUNSELING INC
Practice address
465 SE Riverside Dr
Stuart, FL 34994-2584
Phone
(772) 207-0716
Fax
(877) 857-2217
NPI assigned
Apr 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Catherina PopaNPI 1922411917
Title
President
Phone
(772) 812-7907

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X SW13243 FL Primary

Addresses

Primary practice location

465 SE Riverside Dr
Stuart, FL 34994-2584

Mailing address

465 SE Riverside Dr
Stuart, FL 34994-2584
Phone (772) 207-0716

Other identifiers 2

IdentifierTypeStateIssuer
1922411917MedicaidFL
1598205833MedicaidFL

National Provider Directory

National Provider Directory

Locations

465 SE Riverside Dr
Stuart, FL 34994
Phone (772) 207-0716

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": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1265967830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SE RIVERSIDE DR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942584",
            "telephone_number": "772-207-0716",
            "fax_number": "877-857-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SE RIVERSIDE DR",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942584",
            "telephone_number": "772-207-0716",
            "fax_number": "877-857-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINESCENCE COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "POPA",
        "authorized_official_first_name": "CATHERINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-812-7907"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922411917",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598205833",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.