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Organization
THE LUMINESCENT MIND, LLC
Active
Organization
THE LUMINESCENT MIND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERYNE PUENTES PH.D., LMHC, LMFT (CEO/FOUNDER/LMHC/LMFT)
(786) 266-0108
Entity
Organization
Contact information
Practice address
7901 4TH ST N STE 4000, ST PETERSBURG, FL 33702-4305
(786) 266-0108
Mailing address
7901 4TH ST N STE 4000, ST PETERSBURG, FL 33702-4305
(786) 266-0108
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/13/2023
Last updated
06/15/2023
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