Moon Rising LLC

NPI #1205646775 in Pensacola, Florida

Provider Information

NPI Number: 1205646775
Entity Type: Organization
Organization Name: Moon Rising LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jan 8, 2025
Last Updated: Jan 8, 2025

Practice Location

Address: 4400 BAYOU BLVD STE 21
City: Pensacola
State: Florida
ZIP Code: 32503-1908
Phone: (850) 270-7295

Authorized Official

Name: VIRGINIA WALLS
Title: OWNER
Phone: (850) 270-7295

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Group Psychotherapy — Group Psychotherapy	103TP2701X
Marriage & Family Therapist	106H00000X
Counselor	101Y00000X
Counselor - Professional — Professional	101YP2500X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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