Therapy by Moonlight, Inc.; Imari Childs, LCSW

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

THERAPY BY MOONLIGHT, INC.; IMARI CHILDS, LCSW

Practice address

4058 Orange Ave
Long Beach, CA 90807-3717

Phone

(310) 362-4047

NPI assigned

Jan 6, 2022

Organization subpart

No

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

Authorized official

Name

Imari Childs, LCSWNPI 1538617428

Title

Ceo

Phone

(415) 637-0232

Specialties & licenses 4

Addresses

Other names 2

• Therapy By Moonlight Other name
• Therapy By Moonlight, Inc. Other name

Locations

Practitioners 1

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

• Imari Billy Childs, LCSW

  • Clinical Social Worker
  • Long Beach, CA
  • NPI 1538617428
  NPD Authorized official

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1780345348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6078 KINGWOOD CIR APT 76",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773473",
            "telephone_number": "415-637-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4058 ORANGE AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073717",
            "telephone_number": "310-362-4047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3685 Motor Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900345746",
            "country_code": "US",
            "telephone_number": "310-362-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPY BY MOONLIGHT, INC.; IMARI CHILDS, LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "IMARI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-637-0232",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Therapy By Moonlight",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Therapy By Moonlight, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Alexandra Themoleas
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• Louis P Theriot, M.D.
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• Sharmila R Thiagarajan, MD
• Ryann Thibodeaux
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• Multi-Specialty Clinic/Center in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.