Organization Active NPI

Moston Legacy LLC

  • Marriage & Family Therapist
  • Madison, WI
National Provider Identifier
1780447565
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
MOSTON LEGACY LLC
Practice address
740 Regent St Ste 105
Madison, WI 53715-2648
Phone
(608) 305-4221
NPI assigned
Feb 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Authorized official

Name
Molly Spaeni, MS, LMFTNPI 1902215841
Title
Marriage and Family Therapist
Phone
(608) 305-4221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

740 Regent St Ste 105
Madison, WI 53715-2648

Mailing address

740 Regent St Ste 105
Madison, WI 53715-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260108000183 WI Part B Supplier - Clinic/Group Practice 9830675081 Receives reassigned benefits from 1 practitioner
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Locations

740 Regent St
Ste 105
Madison, WI 53715
Phone (608) 305-4221

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1780447565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 REGENT ST STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 REGENT ST STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152648",
            "telephone_number": "608-305-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSTON LEGACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "SPAENI",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "MARRIAGE AND FAMILY THERAPIST",
        "authorized_official_telephone_number": "608-305-4221",
        "authorized_official_credential": "MS, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.