MEDICARE: PAPER MOON COUNSELING

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1255225819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAPER MOON COUNSELING

Provider Business Mailing Address
First Line	:	11010 LAKE GROVE BLVD STE 100-232
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-7391
Country	:	US
Telephone Number	:	919-378-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	11010 LAKE GROVE BLVD STE 100-232
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-7391
Country	:	US
Telephone Number	:	919-378-0366
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICIAN
Name	:	TRACEY STRACENER
Credential	:	LCMHCS
Telephone Number	:	828-320-9363

Provider Enumeration Date	:	06/06/2025
Last Update Date	:	06/06/2025

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Directions to “PAPER MOON COUNSELING ” Practice Location

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