Blue Moon Therapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE MOON THERAPY, PLLC

Practice address

23144 Cinco Ranch Blvd # B-1105
Katy, TX 77494-2894

Phone

(832) 535-2616

NPI assigned

Jan 25, 2022

Organization subpart

No

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

Authorized official

Name

Angela Bailey, LCSWNPI 1588322499

Title

Therapist

Phone

(832) 600-2493

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Angela Bailey, LCSW

  • Clinical Social Worker
  • Katy, TX
  • NPI 1588322499
  NPD Authorized official

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1972255560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8515 SPOTSLYVANIA LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770836437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23144 CINCO RANCH BLVD # B-1105",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774942894",
            "telephone_number": "832-535-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOON THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "832-600-2493",
        "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": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "therapy@bluemoon-llc.com",
            "affiliation": "N",
            "address_1": "9476 Highway 6 S Ste 129",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770836307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinical Social Worker in Katy, TX
• Providers in Katy, TX by specialty
• Clinical Social Worker in Texas

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