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NPI Code Detail

MEDICARE: MOONSTONE SPRINGS COUNSELING PLLC

MEDICARE: MOONSTONE SPRINGS COUNSELING PLLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1255039632
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOONSTONE SPRINGS COUNSELING PLLC
Provider Business Mailing Address
First Line : 3060 N ACADEMY BLVD STE 300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5349
Country : US
Telephone Number : 719-828-5560
Fax Number : 719-465-5272
Provider Business Practice Location Address
First Line : 3060 N ACADEMY BLVD STE 300
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-5349
Country : US
Telephone Number : 719-828-5560
Fax Number : 719-465-5272
Authorized Official
Title or Position : THERAPIST/CO-OWNER
Name : MARY LAUREN FOY
Credential : LPC
Telephone Number : 719-828-5560
Provider Enumeration Date : 02/15/2023
Last Update Date : 01/07/2025

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Directions to “MOONSTONE SPRINGS COUNSELING PLLC ” Practice Location

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