Organization Active NPI

Moon River Counseling LLC

  • Clinical Social Worker
  • Savannah, GA
National Provider Identifier
1831733450
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MOON RIVER COUNSELING LLC
Practice address
340 Eisenhower Dr Ste 300B
Savannah, GA 31406-2683
Phone
(912) 244-2071
NPI assigned
Nov 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Brittaney Baskin Brackett, LCSWNPI 1932605045
Title
Owner/Clinician
Phone
(912) 244-2071

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

340 Eisenhower Dr Ste 300B
Savannah, GA 31406-2683

Mailing address

340 Eisenhower Dr Ste 300B
Savannah, GA 31406-2683
Phone (901) 486-2230

National Provider Directory

National Provider Directory

Locations

340 Eisenhower Dr
Ste 300B
Savannah, GA 31406
Phone (912) 244-2071

6911 Skidaway Rd
Savannah, GA 31406

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": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1831733450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR STE 300B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062683",
            "telephone_number": "901-486-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EISENHOWER DR STE 300B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062683",
            "telephone_number": "912-244-2071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON RIVER COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "BRACKETT",
        "authorized_official_first_name": "BRITTANEY",
        "authorized_official_middle_name": "BASKIN",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "912-244-2071",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.