Provider Demographics
NPI:1336027143
Name:LUMINARA INTEGRATIVE PSYCHIATRY
Entity type:Organization
Organization Name:LUMINARA INTEGRATIVE PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-445-1631
Mailing Address - Street 1:27 S WATERFORD RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-7752
Mailing Address - Country:US
Mailing Address - Phone:610-420-8832
Mailing Address - Fax:
Practice Address - Street 1:27 S WATERFORD RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:PA
Practice Address - Zip Code:18414-7752
Practice Address - Country:US
Practice Address - Phone:610-420-8832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1811756240Medicaid
PA1902780901Medicaid