Mindful Moon Mental Health LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MINDFUL MOON MENTAL HEALTH LLC

Practice address

8316 Holly Dr
Canton, MI 48187-4238

Phone

(734) 564-0019

NPI assigned

Dec 6, 2024

Last updated

Dec 6, 2024By 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

Staci L Hissong, MA, LPC

Title

Owner/Therapist

Phone

(734) 564-0019

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Staci Lynn Belair, LPC

  • Professional Counselor
  • Livonia, MI
  • NPI 1669710265
  NPD

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1801602677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 HOLLY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874238",
            "telephone_number": "734-564-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 HOLLY DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874238",
            "telephone_number": "734-564-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL MOON MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "HISSONG",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "734-564-0019",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Miller
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• Nancy Miller, CTRS
• Stephanie Millerwise
• Johnna Pilar Mills, D.D.S.
• Minding Mind Biznezz, LLC
• Nicholas Minichiello
• Kerry Anne Minshew, LPC
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• Alyssa Marie Mireles, DPT

• Professional Counselor in Canton, MI
• Providers in Canton, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.