Jessica Sungae Moon

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC007968 Issued in PA

Practice address

136 S Main St
North Wales, PA 19454-2863

Phone

(609) 358-0508

NPI assigned

Jun 23, 2025

Last updated

Jun 23, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1386531168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 GREYCLIFFE LN",
            "city": "AMBLER",
            "state": "PA",
            "postal_code": "190021951",
            "telephone_number": "267-255-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S MAIN ST",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194542863",
            "telephone_number": "609-358-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JESSICA",
        "middle_name": "SUNGAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usman Ahmed Mirza, RPH
• Matthew Booth Mitchell, D.C.
• Montgomery County Wellness Center (Montgomery County Chiropractic Center)
• Montgomery Mall Dental, LLP
• Montgomery Smile Center LLC (Montgomery Mall Smile Center)
• Ji Weon Moon, ACUPUNCTURIST
• Sunghoon Moon
• Regina Adell Moore-Williams, OTR/L
• Heather E Moore, DPT
• Heather Elizabeth Morris, PA-C

• Professional Counselor in North Wales, PA
• Providers in North Wales, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.