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General NPI Number Information
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NPI Number | 1003777889
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Entity Type | Organization
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Legal Business Name | MOONRISE THERAPY, PLLC
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 9150 ORANGE HORIZON AVE
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City | LAS VEGAS
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State | NV
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Zip | 89148-1578
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Country | US
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Telephone | 702-718-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 732 S 6TH ST STE N
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City | LAS VEGAS
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State | NV
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Zip | 89101-6928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PROFESSIONAL COUNSELOR
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Name | MISS SARAH DAWN POIRIER
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Credential | CPC
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Telephone | 702-718-7935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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