Provider Demographics
NPI:1932082401
Name:LUMINOUS MINDS, LLC
Entity type:Organization
Organization Name:LUMINOUS MINDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LMHC
Authorized Official - Phone:269-224-0977
Mailing Address - Street 1:210 E MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-2376
Mailing Address - Country:US
Mailing Address - Phone:269-224-0977
Mailing Address - Fax:269-224-0978
Practice Address - Street 1:210 E MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-2376
Practice Address - Country:US
Practice Address - Phone:269-224-0977
Practice Address - Fax:269-224-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health