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Organization

LUMINA CHILD & FAMILY COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON F ZOELLERS LPC (OWNER/COUNSELOR)
(573) 673-9546
Entity
Organization

Contact information

Practice address
601 W NIFONG BLVD, SUITE 1B, COLUMBIA, MO 65203-6804
(573) 442-9669
(573) 442-9670
Mailing address
601 W NIFONG BLVD, SUITE 1B, COLUMBIA, MO 65203-6804
(573) 442-9669
(573) 442-9670

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2003031572
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11558000
CAQH
MO
01
1619938875
NPI, INDIVIDUAL
MO
05
491362505
MO
Enumeration date
01/14/2008
Last updated
10/30/2012
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