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General NPI Number Information
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NPI Number | 1376255463
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Entity Type | Organization
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Legal Business Name | NEW MOON MENTAL HEALTH COUNSELING
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Dates
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Enumeration Date | 12/20/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 13023 SW 113TH PL
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City | MIAMI
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State | FL
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Zip | 33176-8339
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Country | US
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Telephone | 305-753-2336
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Fax |
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Provider Business Mailing Address
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Address Line | 13023 SW 113TH PL
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City | MIAMI
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State | FL
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Zip | 33176-8339
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Country | US
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Telephone | 305-753-2336
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATALIA AZUCENA
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Credential | LCSW
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Telephone | 305-753-2336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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