Healthcare Provider Details

I. General information

NPI: 1932037173
Provider Name (Legal Business Name): MOONSTONE BEHAVIORAL HEALTH SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4819 EMPEROR BLVD STE 400
DURHAM NC
27703-5420
US

IV. Provider business mailing address

4819 EMPEROR BLVD STE 400
DURHAM NC
27703-5420
US

V. Phone/Fax

Practice location:
  • Phone: 984-310-2151
  • Fax:
Mailing address:
  • Phone: 984-310-2151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BROOKE OWENS
Title or Position: OWNER/ THERAPIST
Credential: LCSW, LCAS, CCS
Phone: 919-332-8129