MEDICARE: MOONLIGHT HEALING AND WELLNESS CENTER INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1649109505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOONLIGHT HEALING AND WELLNESS CENTER INCORPORATED

Provider Business Mailing Address
First Line	:	5767 VIENNA DR
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-4060
Country	:	US
Telephone Number	:	614-695-2602
Fax Number	:

Provider Business Practice Location Address
First Line	:	5767 VIENNA DR
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-4060
Country	:	US
Telephone Number	:	614-695-2602
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LIBAN BULE
Credential	:
Telephone Number	:	614-695-2602

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

Similar Medicare Providers

1124374525 — CENTENIAL HOME HEALTH CARE, LLC
Practice Location Address:

5767 VIENNA DR
WESTERVILLE, OH
43081-4060

Practice Phone: 614-397-1150
Practice Fax:

1699351510 — PATRICK MICHAEL WIELAND MD
Practice Location Address:

6100 N HAMILTON RD
WESTERVILLE, OH
43081-2062

Practice Phone: 614-293-3230
Practice Fax: 614-293-4030

1912836610 — AMIR HOME CARE LLC
Practice Location Address:

6015 WHITNEY KATHLEEN RD.
WESTERVILLE, OH
43081

Practice Phone: 220-262-5178
Practice Fax:

1346026093 — SHUNELLE HOLLIS LSW
Practice Location Address:

5107 FAIRWAY LAKES DR
WESTERVILLE, OH
43081-5209

Practice Phone: 773-426-8428
Practice Fax:

1437459336 — MRS. MICHELLE M IRWIN LPN
Practice Location Address:

26 S SUMMIT ST
WESTERVILLE, OH
43081-1621

Practice Phone: 614-218-8880
Practice Fax:

1427727601 — KATHERINE TIERNEY BECHER APRN-CNP
Practice Location Address:

6100 N HAMILTON RD
WESTERVILLE, OH
43081-2062

Practice Phone: 614-366-4272
Practice Fax: 614-366-9440

Directions to “MOONLIGHT HEALING AND WELLNESS CENTER INCORPORATED ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.