MOONLIGHT MENTAL HEALTH NPI 1780276451

NPI Information

NPI: 1780276451
Provider Name: MOONLIGHT MENTAL HEALTH
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
211 S MAIN
BENTON, AR
ZIP 72015
Phone: (662) 727-1053
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MOONLIGHT MENTAL HEALTH is a mental health counselor in Benton, AR. MOONLIGHT MENTAL HEALTH NPI is 1780276451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

211 S MAIN
BENTON, AR
ZIP 72015-331
Phone: (662) 727-1053
Fax: (501) 214-6867

The provider's authorized official is Lauren Johnson .
The authorized official title is Owner and has the following contact phone number (501) 278-1736.

The enumeration date for this NPI number is 2/4/2021 and was last updated on 2/4/2021.

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
1	101YM0800X	Counselor	Mental Health			Yes

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: 4/28/2024

NPI Synchronization or Removal

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