Blue Moon Therapy Llc

LBN: Blue Moon Therapy Llc
Blue Moon Therapy Llc is an health care organization with primary practice located at 400 N Woodlawn Suite 100, Wichita KS 67216-1360. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Blue Moon Therapy Llc can be contacted via phone (316) 652-2580, or through Goodwin, Shannon D. via phone (316) 249-4447.

Contact Information

Primary practice address
400 N Woodlawn Suite 100 Wichita KS 67216-1360
Phone: (316) 652-2580
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Goodwin, Shannon D. LSCSW
Phone: (316) 249-4447

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1205319472
LBN Legal business name Blue Moon Therapy Llc
DBA Doing business as
Authorized official Goodwin, Shannon D. LSCSW
Entity Organization
Organization subpart 1 No
Enumeration date Sep 12th, 2018
Last updated Sep 12th, 2018 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers