Healthcare Provider Details

I. General information

NPI: 1033066634
Provider Name (Legal Business Name): MOON DROP THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 WASHINGTON ST NE
ALBUQUERQUE NM
87108-1156
US

IV. Provider business mailing address

533 WASHINGTON ST NE
ALBUQUERQUE NM
87108-1156
US

V. Phone/Fax

Practice location:
  • Phone: 505-785-7447
  • Fax:
Mailing address:
  • Phone: 505-785-7447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN ARAGON
Title or Position: THERAPIST
Credential: LCSW, LSAA
Phone: 505-785-7447