NPIMap

Organization Active NPI

Mooncalf, LLC

  • Mental Health Counselor
  • Mission, KS
National Provider Identifier
1942823034
Registry record updated May 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MOONCALF, LLC
Doing business as
Flyover Counseling
Practice address
6029 Broadmoor St Unit 234
Mission, KS 66201-2475
Phone
(515) 758-0358
NPI assigned
May 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2020

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

Authorized official

Name
Cassandra Walker, LCPCNPI 1295065589
Title
Clinical Director
Phone
(515) 758-0358

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

6029 Broadmoor St Unit 234
Mission, KS 66201-2475

Mailing address

6029 Broadmoor St Unit 234
Mission, KS 66201-2475
Phone (515) 758-0358

Other names 1

  • Flyover Counseling Doing business as

National Provider Directory

National Provider Directory

Locations

6029 Broadmoor St
Unit 234
Mission, KS 66201
Phone (515) 758-0358

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": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1942823034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6029 BROADMOOR ST UNIT 234",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662012475",
            "telephone_number": "515-758-0358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6029 BROADMOOR ST UNIT 234",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662012475",
            "telephone_number": "515-758-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONCALF, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "515-758-0358",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Flyover Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; 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.