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General NPI Number Information
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NPI Number | 1902557267
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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 | 01/18/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 10832 SW 88TH ST APT U7
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City | MIAMI
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State | FL
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Zip | 33176-1390
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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 | 10832 SW 88TH ST APT U7
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City | MIAMI
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State | FL
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Zip | 33176-1390
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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 | OWNER
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Name | NATALIA AZUCENA
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Credential |
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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 | 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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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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