NPIMap

Organization Active NPI

Purple Moon Service Center, LLC

  • Mental Health Counselor
  • Jacksonville, FL
National Provider Identifier
1194450676
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PURPLE MOON SERVICE CENTER, LLC
Doing business as
Purple Moon Service Center,LLC
Practice address
931 Cassat Ave
Jacksonville, FL 32205-4857
Phone
(904) 233-1019
Fax
(904) 369-4666
NPI assigned
Jul 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Authorized official

Name
Ms. Valjeanne R Caster, LMHC, MAC, CAMSII,NPI 1598190746
Title
Counselor -Owner
Phone
(904) 233-1019

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

931 Cassat Ave
Jacksonville, FL 32205-4857

Mailing address

931 Cassat Ave
Jacksonville, FL 32205-4857
Phone (904) 233-1019

Other names 1

  • Purple Moon Service Center,LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL TherapyNotes Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1194450676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 CASSAT AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322054857",
            "telephone_number": "904-233-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 CASSAT AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322054857",
            "telephone_number": "904-233-1019",
            "fax_number": "904-369-4666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPLE MOON SERVICE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "CASTER",
        "authorized_official_first_name": "VALJEANNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "COUNSELOR -OWNER",
        "authorized_official_telephone_number": "904-233-1019",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMHC, MAC, CAMSII,"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "TherapyNotes",
            "affiliation": "N",
            "endpointDescription": "My electronic health care company is Therapy Notes",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "931 Cassat Ave",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322054857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Purple Moon Service Center,LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.