JACQUELINE MOON NPI 1588011464

NPI Information

  • NPI: 1588011464
  • Provider Name: JACQUELINE MOON
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 368 VETERANS MEMORIAL HWY STE 3
    COMMACK, NY
    ZIP 11725
  • Phone: (631) 533-0315

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NPI Details

Jacqueline Moon is a mental health counselor in Commack, NY with 9 years of experience. Jacqueline Moon NPI is 1588011464. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

368 VETERANS MEMORIAL HWY STE 3
COMMACK, NY
ZIP 11725-322
Phone: (631) 533-0315

The NPI 1588011464 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 5/19/2016 and was last updated on 12/18/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health012058NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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