Organization
LUMOS ENTERPRISES LLC
Active
Other names
Lumos Youth Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA S. VINEYARD (CEO)
(801) 915-6007
Entity
Organization
Contact information
Practice address
14241 S REDWOOD RD STE 300, BLUFFDALE, UT 84065-5223
(385) 342-2808
Mailing address
PO BOX 1270, RIVERTON, UT 84065-1270
(801) 915-6007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
163W00000X
Registered Nurse
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
251300000X
Local Education Agency (LEA)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
08/22/2022
Last updated
07/22/2023
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