Organization
LUMOS PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY GORDON WALTER PMHNP-BC (OWNER/PRESIDENT)
(843) 412-5160
Entity
Organization
Contact information
Practice address
3013 QUEENSBERRY DR, HUNTINGTOWN, MD 20639-2304
(843) 412-5160
Mailing address
3013 QUEENSBERRY DR, HUNTINGTOWN, MD 20639-2304
(843) 412-5160
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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