MEDICARE: NEW MOON THERAPY SERVICES 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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831847508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW MOON THERAPY SERVICES LLC

Provider Business Mailing Address
First Line	:	1367 TARA RD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5131
Country	:	US
Telephone Number	:	412-780-4035
Fax Number	:	866-394-5788

Provider Business Practice Location Address
First Line	:	1367 TARA RD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-5131
Country	:	US
Telephone Number	:	412-780-4035
Fax Number	:	866-394-5788

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	RACHEL LAUREN NOVAKOVICH
Credential	:	DPT
Telephone Number	:	412-780-4035

Provider Enumeration Date	:	03/12/2022
Last Update Date	:	02/06/2026

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Directions to “NEW MOON THERAPY SERVICES LLC ” Practice Location

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