Healthcare Provider Details

I. General information

NPI: 1831847508
Provider Name (Legal Business Name): NEW MOON THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1367 TARA RD
CHARLESTON SC
29407-5131
US

IV. Provider business mailing address

1367 TARA RD
CHARLESTON SC
29407-5131
US

V. Phone/Fax

Practice location:
  • Phone: 412-780-4035
  • Fax: 866-394-5788
Mailing address:
  • Phone: 412-780-4035
  • Fax: 866-394-5788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RACHEL LAUREN NOVAKOVICH
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 412-780-4035