Crescent Moon Counseling, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C002534 Issued in NC

Legal business name

CRESCENT MOON COUNSELING, INC.

Practice address

221 Orange St
Henderson, NC 27536-4234

Phone

(252) 431-0075

NPI assigned

Dec 21, 2009

Organization subpart

No

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

Authorized official

Name

Sandi Gray-Terry, MSW, LCSW

Title

Owner

Phone

(252) 431-0075

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Sandi Gray-Terrry, MSW, LCSW Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Gray-Terry, MSW, LCSW

  • Clinical Social Worker
  • Henderson, NC
  • NPI 1124052055
  NPD (past)

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261353600000",
    "number": "1740519875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 N MANGUM ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277011311",
            "telephone_number": "252-431-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 ORANGE ST",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275364234",
            "telephone_number": "252-431-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT MOON COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A",
        "authorized_official_last_name": "GRAY-TERRY",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-431-0075",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C002534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-NC",
            "identifier": "36593",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003804",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sandi Gray-Terrry, MSW, LCSW",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• John Culp, CRNA
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• D Michael Mahan MD PA
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• D&D Care Services

• Clinical Social Worker in Henderson, NC
• Providers in Henderson, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.