Organization Active NPI

Moon Mental Health PLLC

  • Psychiatry Physician
  • Paoli, PA
National Provider Identifier
1881288892
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MOON MENTAL HEALTH PLLC
Practice address
1710 E Lancaster Ave # 302
Paoli, PA 19301-1507
Phone
(925) 238-8130
NPI assigned
Feb 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Jennifer L SweetNPI 1780909747
Title
Co-Founder
Phone
(857) 273-1023

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
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1710 E Lancaster Ave # 302
Paoli, PA 19301-1507

Mailing address

1710 E Lancaster Ave # 302
Paoli, PA 19301-1507

National Provider Directory

National Provider Directory

Locations

1710 Lancaster Ave
#302
Paoli, PA 19301
Phone (857) 273-1023

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": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1881288892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 E LANCASTER AVE # 302",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 E LANCASTER AVE # 302",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011507",
            "telephone_number": "925-238-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOON MENTAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "SWEET",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "857-273-1023"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.