| Luminous Self Pllc | |
|
119 Sader Dr Ste 4 Inwood WV 25428-3915 | |
| (240) 406-9339 | |
| Not Available |
| Full Name | Luminous Self Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 119 Sader Dr Ste 4, Inwood, West Virginia |
| Authorized Official Name and Position | Rachel Rhiannon Davis (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2404069339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminous Self Pllc 119 Sader Dr Ste 4 Inwood WV 25428-3915 Ph: (240) 406-9339 | Luminous Self Pllc 119 Sader Dr Ste 4 Inwood WV 25428-3915 Ph: (240) 406-9339 |
| NPI Number | 1366134561 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 07/21/2023 |
| Certification Date | 07/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366134561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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