Healthcare Provider Details

I. General information

NPI: 1821956863
Provider Name (Legal Business Name): NEW MOON COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 N 2ND ST STE B
CLINTON IA
52732-3750
US

IV. Provider business mailing address

927 N 2ND ST STE B
CLINTON IA
52732-3750
US

V. Phone/Fax

Practice location:
  • Phone: 563-249-8007
  • Fax:
Mailing address:
  • Phone: 563-249-8007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY PAIGE HICKSON
Title or Position: OWNER/PROVIDER
Credential: LISW
Phone: 563-249-8007