MEDICARE: CRESCENT MOON WELLNESS, 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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1619811718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT MOON WELLNESS, PLLC

Provider Business Mailing Address
First Line	:	605 E LAVENDER AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-4531
Country	:	US
Telephone Number	:	973-800-3401
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 E LAVENDER AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27704-4531
Country	:	US
Telephone Number	:	973-800-3401
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNA E NAJJAR
Credential	:	LCSW
Telephone Number	:	973-800-3401

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

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