Moon Wellness LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MOON WELLNESS LLC

Practice address

488 N Main St Ste 2N
Glen Ellyn, IL 60137-5126

Phone

(630) 296-7073

NPI assigned

Aug 21, 2023

Last updated

Aug 21, 2023By 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

Katharine Moon Raess, LCPCNPI 1740632041

Title

Clinical Therapist

Phone

(660) 341-1071

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Katharine Moon Raess

  • Professional Counselor
  • Glen Ellyn, IL
  • NPI 1740632041
  NPD Authorized official

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1588448658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 N SUMMIT ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874454",
            "telephone_number": "660-341-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 N MAIN ST STE 2N",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375126",
            "telephone_number": "630-296-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "MOON RAESS",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "660-341-1071",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MLM USA LLC (Beltone Hearing)
• William Peter Moeller, LCSW
• Mahmuda Sultana Mohsin, M.D.
• Alexandra Molina
• Katharine Moon Raess
• Derek Raymond Moore, CADC
• Terence Moore
• Kelsie Jane Moosmann, OTR/L
• Jacqueline Moran, MD
• Julie M Moreschi, MS RDN LDN

• Mental Health Counselor in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.