Provider Demographics
NPI:1578306437
Name:JURD, LUNA (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:LUNA
Middle Name:
Last Name:JURD
Suffix:
Gender:X
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 121835
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-7835
Mailing Address - Country:US
Mailing Address - Phone:855-579-5323
Mailing Address - Fax:855-579-5323
Practice Address - Street 1:101 E RANDOL MILL RD STE 100
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5800
Practice Address - Country:US
Practice Address - Phone:855-579-5323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95349101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional