Healthcare Provider Details

I. General information

NPI: 1003740580
Provider Name (Legal Business Name): MOONFLOWER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2814 DETROIT AVE
CLEVELAND OH
44113-2708
US

IV. Provider business mailing address

2814 DETROIT AVE
CLEVELAND OH
44113-2708
US

V. Phone/Fax

Practice location:
  • Phone: 216-200-6999
  • Fax:
Mailing address:
  • Phone: 216-200-6999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL LINDENMEIER
Title or Position: CLINICAL MENTAL HEALTH COUNSELOR
Credential: LPCC
Phone: 216-200-6999