Active NPI
Stefanie Moon
- Professional Counselor
- Fairborn, OH
National Provider Identifier
1346891009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C.2507154
- Practice address
- 1457 Spicetree Cir Apt 202
Fairborn, OH 45324-7105 - Phone
- (937) 408-5900
- NPI assigned
- Sep 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Professional Counselor | 101YP2500X | C.2507154 | OH | Primary |
Addresses
Primary practice location
1457 Spicetree Cir Apt 202
Fairborn, OH 45324-7105
Mailing address
1457 Spicetree Cir Apt 202
Fairborn, OH 45324-7105
Phone (937) 408-5900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3170 Kettering Blvd
Moraine, OH 45439-1924
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C.2507154 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769385600000",
"number": "1346891009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1457 SPICETREE CIR APT 202",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453247105",
"telephone_number": "937-408-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1457 SPICETREE CIR APT 202",
"city": "FAIRBORN",
"state": "OH",
"postal_code": "453247105",
"telephone_number": "937-408-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "STEFANIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-24",
"last_updated": "2026-01-26",
"certification_date": "2026-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.2507154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairborn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.