| The Luman Project | |
|
2629 Cold Stream Ln Green Cove Springs FL 32043-8623 | |
| (904) 863-6001 | |
| Not Available |
| Full Name | The Luman Project |
|---|---|
| Speciality | Counselor |
| Location | 2629 Cold Stream Ln, Green Cove Springs, Florida |
| Authorized Official Name and Position | Maryam Archer (OWNER/CLINICIAN) |
| Authorized Official Contact | 4252806715 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Luman Project 5000 Us Highway 17 # 18-418 Fleming Island FL 32003-8231 Ph: (904) 863-6001 | The Luman Project 2629 Cold Stream Ln Green Cove Springs FL 32043-8623 Ph: (904) 863-6001 |
| NPI Number | 1932984382 |
|---|---|
| Provider Enumeration Date | 08/25/2023 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Medicare PECOS PAC ID | 5092165290 |
|---|---|
| Medicare Enrollment ID | O20240102000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932984382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Maryam Archer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427639046 PECOS PAC ID: 6901256106 Enrollment ID: I20240102000008 |
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