Organization Active NPI

Luna Therapy Services

  • Professional Counselor
  • Burnsville, MN
National Provider Identifier
1346954690
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
LUNA THERAPY SERVICES
Practice address
14041 Burnhaven Dr Ste 125
Burnsville, MN 55337-4408
Phone
(612) 702-6012
NPI assigned
Jan 11, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Michaela Arellano, MPS, LPCC, LADCNPI 1942867783
Title
Owner
Phone
(612) 702-6012

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

14041 Burnhaven Dr Ste 125
Burnsville, MN 55337-4408

Mailing address

14041 Burnhaven Dr Ste 125
Burnsville, MN 55337-4408
Phone (612) 702-6012

Other identifiers 1

IdentifierTypeStateIssuer
1942867783OtherNPPES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121000521 MN Part B Supplier - Clinic/Group Practice 3173052164 Receives reassigned benefits from 2 practitioners
Practice locations: Burnsville, MN

National Provider Directory

National Provider Directory

Locations

14041 Burnhaven Dr
Ste 125
Burnsville, MN 55337
Phone (612) 440-8750

Practitioners & affiliated clinicians

Practitioners 2

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": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1346954690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14041 BURNHAVEN DR STE 125",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374408",
            "telephone_number": "612-702-6012",
            "fax_number": "888-407-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14041 BURNHAVEN DR STE 125",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374408",
            "telephone_number": "612-702-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNA THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "ARELLANO",
        "authorized_official_first_name": "MICHAELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-702-6012",
        "authorized_official_credential": "MPS, LPCC, LADC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1942867783",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.