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General NPI Number Information
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NPI Number | 1861349151
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Entity Type | Organization
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Legal Business Name | NEW MOON MENTAL HEALTH COUNSELING SERVICES, PC
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Dates
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Enumeration Date | 03/14/2026
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Last Update Date | 03/14/2026
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Provider Practice Location Address
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Address Line | 155 E MAIN ST STE 260
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City | SMITHTOWN
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State | NY
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Zip | 11787-2870
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Country | US
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Telephone | 631-365-4822
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Fax |
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Provider Business Mailing Address
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Address Line | 155 E MAIN ST STE 260
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City | SMITHTOWN
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State | NY
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Zip | 11787-2870
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Country | US
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Telephone | 631-365-4822
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE RICCIO
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Credential | LMHC, NCC
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Telephone | 631-365-4822
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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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