Moonbrook Mind & Body Integrative Services Incorporated

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED

Practice address

421 Pecan St
Texarkana, AR 71854-5333

Phone

(870) 330-4095

Fax

(844) 706-5741

NPI assigned

Jan 16, 2020

Last updated

Jan 20, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica KenningtonNPI 1902219587

Title

Owner

Phone

(870) 330-4095

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 4

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.

• Jessica Kennington, LCSW

  • Clinical Social Worker
  • Texarkana, AR
  • NPI 1902219587
  Medicare reassignment Care Compare group NPD Authorized official
• Kelli Mayall, LPC

  • Mental Health Counselor
  • Texarkana, AR
  • NPI 1952894545
  Medicare reassignment Care Compare group NPD
• Alana Beth Mrugala, LPC

  • Mental Health Counselor
  • Clarksville, TN
  • NPI 1093399198

  AR

  Medicare reassignment
• Melissa Pierce

  • Mental Health Counselor
  • New Boston, TX
  • NPI 1417483272
  NPD (past)

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1376173401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 PECAN ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545333",
            "telephone_number": "870-330-4095",
            "fax_number": "844-706-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 PECAN ST",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718545333",
            "telephone_number": "870-330-4095",
            "fax_number": "844-706-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONBROOK MIND & BODY INTEGRATIVE SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "KENNINGTON",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-330-4095"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica@Moonbrookmindbody.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "421 Pecan St",
            "city": "Texarkana",
            "state": "AR",
            "country_code": "US",
            "postal_code": "718545333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James Miller III, M.D.
• Teresa Milner
• Mary Mobley
• Glen Owen Monk
• Jesse Louis Montgomery III, MHPP
• Kita Renee Mooneyham, COTA
• Callie Moore
• Joseph Eugene Moore, MD
• Kelley Rene Moore, MHPP
• Jerry Franklin Morgan Jr., RPH

• Clinical Social Worker in Texarkana, AR
• Providers in Texarkana, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.