NPIMap

Organization Active NPI

Luminous Mind Foundation Incorporated

  • Community/Behavioral Health Agency
  • Santa Teresa, NM
National Provider Identifier
1841090925
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LUMINOUS MIND FOUNDATION INCORPORATED
Practice address
1301 Country Club Rd
Santa Teresa, NM 88008-9431
Phone
(915) 260-8113
Fax
(833) 428-3821
NPI assigned
Mar 17, 2025
Last updated
May 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Dr. Marcos Pena, EDD, LCSW, LADACNPI 1235753377
Title
Ceo
Phone
(575) 332-4070

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Community/Behavioral Health Agency 251S00000X Primary
Early Intervention Provider Agency 252Y00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1301 Country Club Rd
Santa Teresa, NM 88008-9431

Mailing address

1301 Country Club Rd
Santa Teresa, NM 88008-9431
Phone (915) 260-8113

Other practice location 1

2601 E Yandell Dr Ste 104
El Paso, TX 79903-3743
Phone (915) 260-8113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250822002518 NM Part B Supplier - Clinic/Group Practice 6204336365 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Teresa, NM
O20250822003026 TX Part B Supplier - Clinic/Group Practice 6204336365 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1841090925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 COUNTRY CLUB RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089431",
            "telephone_number": "915-260-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 COUNTRY CLUB RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089431",
            "telephone_number": "915-260-8113",
            "fax_number": "833-428-3821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2601 E Yandell Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799033743",
            "country_code": "US",
            "telephone_number": "915-260-8113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LUMINOUS MIND FOUNDATION INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "575-332-4070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD, LCSW, LADAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Teresa, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.