Moonrise Therapy PLLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

MOONRISE THERAPY PLLC

Practice address

708 Church St Ste 251
Evanston, IL 60201-3840

Phone

(773) 517-8105

NPI assigned

Nov 7, 2023

Organization subpart

No

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

Authorized official

Name

Darren Diamond

Title

Manager

Phone

(518) 708-5405

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.

• Sarah May Van Nostrand, PSY.D

  • Clinical Psychologist
  • Evanston, IL
  • NPI 1215410899
  NPD (past)

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1649044058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST STE 251",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013840",
            "telephone_number": "773-517-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST STE 251",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013840",
            "telephone_number": "773-517-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONRISE THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "518-708-5405"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Montalvo, LPC, ATR-P
• Martha Iris Montanez
• Carolyn R Montford, PSYD PC
• Marcos Antonio Montoya, D.D.S.
• Tricia Moo-Young, M.D.
• Andrew Hoyt Moore, MD
• Aron Moore
• Elena S. Moore, MD
• Sean Moore, M.D.
• Gayathri S. Moorthy, APN-CNP

• Psychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.