Moon River, LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

MOON RIVER, LLC

Practice address

790 Oak Trail Dr
Marietta, GA 30062-7502

Phone

(770) 977-6866

Fax

(770) 977-6887

NPI assigned

Apr 17, 2006

Last updated

Feb 18, 2025By 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

Laura Desantis

Title

Office Manager

Phone

(770) 212-2170

Specialties & licenses 10

Addresses

Locations

Practitioners 16

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.

• Shequila D Beamer, MS - SLP

  • Speech-Language Pathologist
  • Woodstock, GA
  • NPI 1093395824
  NPD
• Lauren Brougher, OTD

  • Occupational Therapist
  • Roswell, GA
  • NPI 1902658180
  NPD
• Shellie R Davis, CCC-SLP

  • Speech-Language Pathologist
  • Marietta, GA
  • NPI 1962051979
  NPD
• Dimitri Defrant, DPT

  • Physical Therapist
  • Woodstock, GA
  • NPI 1184238040

  Multi-Specialty

  NPD
• Amanda Marie Galagarza, SLP-CLINICAL FELLOW

  • Student in an Organized Health Care Education/Training Program
  • Woodstock, GA
  • NPI 1730819343

  Single Specialty

  NPD
• Shelby Gooden

  • Behavior Analyst
  • Woodstock, GA
  • NPI 1104412840
  NPD
• Kyrei Jendaya Miller, OTR/L

  • Occupational Therapist
  • Woodstock, GA
  • NPI 1851127310
  NPD
• Denise Williams Watson

  • Case Manager/Care Coordinator
  • Marietta, GA
  • NPI 1760263271

  Multi-Specialty

  NPD
• Hannah M Shirah, DPT

  • Physical Therapist
  • Aiken, SC
  • NPI 1003421223

  Multi-Specialty

  NPD
• Mary Elizabeth Golden, BCBA

  • Behavior Analyst
  • Woodstock, GA
  • NPI 1760333041
  NPD (past)
• Susan L Jones, SLP

  • Speech-Language Pathologist
  • Woodstock, GA
  • NPI 1518472158
  NPD (past)
• Lindsay C. McFeeley

  • Speech-Language Pathologist
  • Woodstock, GA
  • NPI 1437639721
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1730143553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 OAK TRAIL DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627502",
            "telephone_number": "770-212-2170",
            "fax_number": "770-783-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 OAK TRAIL DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627502",
            "telephone_number": "770-977-6866",
            "fax_number": "770-977-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON RIVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "DESANTIS",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-212-2170"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT003833",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT 004293",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "GAOT001717",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003992",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005806",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006528",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP 06551",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP 006556",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ngozi Rosalin Monu, MD, PHD
• Samantha Moody, LPC, LMHC
• Tracey E Moody, CMT
• Lauren Moomjian, MD
• Moon River, LLC
• Moon River, LLC
• Jameka Moon
• Lindsay Moon
• Merrie Tanya Moon, P.A.
• Stephanie Yui Moon

• Behavior Analyst in Marietta, GA
• Providers in Marietta, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.