Soo Y Moon, MA, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

2209 Issued in MN

Practice address

1056 Centerville Cir
Vadnais Heights, MN 55127-6360

Phone

(651) 604-7771

Fax

(651) 426-8116

NPI assigned

Dec 29, 2011

Last updated

Nov 26, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Parker Collins Family Mental Health PLLCGroup PAC ID 8325338031, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Parker Collins Family Mental Health, PLLC

  • Community/Behavioral Health Agency
  • Vadnais Heights, MN
  • NPI 1487927067
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416960000000",
    "number": "1548539042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 CENTERVILLE CIR",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276360",
            "telephone_number": "651-604-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 CENTERVILLE CIR",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551276360",
            "telephone_number": "651-604-7771",
            "fax_number": "651-426-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SOO",
        "middle_name": "Y",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2014-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy Scott Miland
• Diandra Shakira Miller, PA-C
• Minnesota Natural Medicine
• Minnesota Natural Medicine
• Elizabeth Claire Mitchell, PA
• Christian Morfaw, MD
• Jeremy Mork, MSW, LICSW
• Wanis Darwish Mousa
• Megan Lynn Mulligan, D.D.S.
• Farhia Mursal, PHARM. D

• Marriage & Family Therapist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; 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.

Verify at the official NPI Registry.