MEDICARE: NEW 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	:	1760249502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW MOON WELLNESS PLLC

Provider Business Mailing Address
First Line	:	80 LOUISIANA AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-3448
Country	:	US
Telephone Number	:	603-247-0850
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 LOUISIANA AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-3448
Country	:	US
Telephone Number	:	603-747-0850
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATHRYN KELLEY
Credential	:	LCSWA/LCAS
Telephone Number	:	603-247-0850

Provider Enumeration Date	:	02/28/2024
Last Update Date	:	06/03/2026

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Directions to “NEW MOON WELLNESS PLLC ” Practice Location

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