Crescent Moon Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

CRESCENT MOON PSYCHIATRY LLC

Practice address

1302 S Shields St Ste A1-2
Fort Collins, CO 80521-4801

Phone

(970) 427-2820

Fax

(970) 585-8169

NPI assigned

Sep 3, 2025

Organization subpart

No

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

Authorized official

Name

Michelle Miranda, PMHNPNPI 1881093607

Title

Owner

Phone

(970) 427-2820

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Miranda, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Collins, CO
  • NPI 1881093607
  NPD Authorized official

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

{
    "created_epoch": "1756857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1063392934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 S SHIELDS ST STE A1-2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805214801",
            "telephone_number": "970-427-2820",
            "fax_number": "970-585-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S SHIELDS ST STE A1-2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805214801",
            "telephone_number": "970-427-2820",
            "fax_number": "970-585-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MOON PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-427-2820",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.