MEDICARE: MOONBEAM THERAPY LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1386593721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOONBEAM THERAPY LLC

Provider Business Mailing Address
First Line	:	3470 E RUSSELL RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-2201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3470 E RUSSELL RD STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-2201
Country	:	US
Telephone Number	:	702-343-0183
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RILEIGH ARD
Credential	:
Telephone Number	:	702-343-0183

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

Similar Medicare Providers

1588514392 — CARE AND DIGNITY HOME HEALTH LLC
Practice Location Address:

3450 E RUSSELL RD STE 130
LAS VEGAS, NV
89120-2201

Practice Phone: 725-204-0082
Practice Fax:

1326039967 — MS. JANET BETH FELDMAN LCSW
Practice Location Address:

3440 E RUSSELL RD , SUITE 227
LAS VEGAS, NV
89120-2201

Practice Phone: 702-438-8407
Practice Fax: 702-438-8407

1689864886 — REBECCA SUZANNE ROGERS MED MSW LSW
Practice Location Address:

3430 E RUSSELL RD STE 315
LAS VEGAS, NV
89120-2201

Practice Phone: 725-238-6990
Practice Fax: 207-510-0562

1497937270 — WENDY NOEL DINGEE MS, LCPC, LCADC, NCC
Practice Location Address:

3470 E RUSSELL RD , STE 206
LAS VEGAS, NV
89120-2201

Practice Phone: 702-604-5579
Practice Fax: 702-589-5894

1235364522 — DR. PHYLLIS MONTAVON PSY.D., LCSW, LCADC
Practice Location Address:

3450 E RUSSELL RD STE 115
LAS VEGAS, NV
89120-2201

Practice Phone: 702-712-5431
Practice Fax: 702-297-6599

1548575681 — MS. CHRISTIE FAYE JOHNSON
Practice Location Address:

3430 E RUSSELL RD STE 315
LAS VEGAS, NV
89120-2201

Practice Phone: 702-527-8351
Practice Fax:

Directions to “MOONBEAM THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.