NPIMap

Organization Active NPI

Crescent Moon Therapy, PLLC

  • Community/Behavioral Health Agency
  • Park Ridge, IL
National Provider Identifier
1013663996
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CRESCENT MOON THERAPY, PLLC
Practice address
1580 N Northwest Hwy Ste 116
Park Ridge, IL 60068-1470
Phone
(847) 975-5128
NPI assigned
Mar 1, 2022
Last updated
Nov 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephanie Defilippis, LCSWNPI 1205416328
Title
Licensed Clinical Social Worker
Phone
(847) 975-5128

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1580 N Northwest Hwy Ste 116
Park Ridge, IL 60068-1470

Mailing address

1580 N Northwest Hwy Ste 116
Park Ridge, IL 60068-1470
Phone (847) 975-5128

Other identifiers 1

IdentifierTypeStateIssuer
1205416328MedicaidIL

National Provider Directory

National Provider Directory

Locations

1580 N Northwest Hwy
Ste 116
Park Ridge, IL 60068
Phone (847) 220-7038

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1013663996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY STE 116",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681470",
            "telephone_number": "847-975-5128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 N NORTHWEST HWY STE 116",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681470",
            "telephone_number": "847-975-5128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MOON THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-01",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "DEFILIPPIS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "847-975-5128",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205416328",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.