Phoenix Moon Healing, Pllc
LBN: Phoenix Moon Healing, Pllc
Phoenix Moon Healing, Pllc is an health care organization with primary practice located at 4601 50Th St Ste 201 , Lubbock TX 79414-3518. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is the primary health care specialty.
Phoenix Moon Healing, Pllc can be contacted via phone (806) 778-1982, or through Luna, Bethany Victoria via phone (806) 778-1982.
Contact Information
Primary practice address
4601 50Th St Ste 201
Lubbock TX 79414-3518
Phone: (806) 778-1982
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X |
Profile Details
| NPI number | 1306519780 |
|---|---|
| LBN Legal business name | Phoenix Moon Healing, Pllc |
| DBA Doing business as | |
| Authorized official | Luna, Bethany Victoria LMFT |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 30th, 2021 |
| Last updated | Jul 30th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306519780 | NPPES |
| Other | 1922367630 | NPI | |
| Other | 1063878015 | NPI |
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