Mossy Pine Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MOSSY PINE THERAPY LLC

Practice address

1901 1/2 N Grand Ave
Las Vegas, NM 87701-5089

Phone

(505) 429-7502

NPI assigned

Jun 6, 2017

Organization subpart

No

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

Authorized official

Name

Felicia Jacqueline Rivera

Title

Director

Phone

(505) 426-6462

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788220800000",
    "number": "1568991453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 1/2 N GRAND AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877015089",
            "telephone_number": "505-426-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 1/2 N GRAND AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877015089",
            "telephone_number": "505-429-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSSY PINE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_middle_name": "JACQUELINE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-426-6462"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Moore, LPCC
• Morada Luz
• Morningstar Personal Care
• Mosaic Remedies
• Susan B Mossman, MA
• Shaelyn Margaret Muldoon
• Susan B Mullen, LPC
• Dominic Mulroy, LMHC
• Amber Lee Munoz, FNP-C
• Richard L Nail, M.D.

• Community/Behavioral Health Agency in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Community/Behavioral Health Agency in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.