MEDICARE: HELPING MOON COUNSELING, P.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083087688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELPING MOON COUNSELING, P.A

Provider Business Mailing Address
First Line	:	6919 SW 18TH ST STE 201
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-7010
Country	:	US
Telephone Number	:	561-571-1557
Fax Number	:	561-634-3536

Provider Business Practice Location Address
First Line	:	6919 SW 18TH ST STE 201
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-7010
Country	:	US
Telephone Number	:	561-571-1557
Fax Number	:	561-634-3536

Authorized Official
Title or Position	:	OWNER
Name	:	LUNA L MEDINA-WOLF
Credential	:	LMHC, CRC
Telephone Number	:	954-309-5353

Provider Enumeration Date	:	11/04/2015
Last Update Date	:	03/22/2022

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