New Moon Bodywork and Wellness

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT4268 Issued in ME

Legal business name

NEW MOON BODYWORK AND WELLNESS

Practice address

16 Elmwood Ave
Westbrook, ME 04092-3717

Phone

(207) 602-8583

NPI assigned

Sep 29, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Catherine Marie Dougherty, LMTNPI 1619427424

Title

Sole Proprietor/Massage Therapist

Phone

(207) 602-8583

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Catherine Marie Dougherty, LMT

  • Massage Therapist
  • Westbrook, ME
  • NPI 1619427424
  NPD (past) Authorized official

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1417406653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAMBERT ST",
            "address_2": "APT 13",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032130",
            "telephone_number": "207-602-8583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 ELMWOOD AVE",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040923717",
            "telephone_number": "207-602-8583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MOON BODYWORK AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "SOLE PROPRIETOR/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "207-602-8583",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT4268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Westbrook, ME
• Providers in Westbrook, ME by specialty
• Massage Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.