Provider Demographics
NPI:1245665686
Name:TURTLEMOON, INC.
Entity type:Organization
Organization Name:TURTLEMOON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:303-905-0994
Mailing Address - Street 1:4628 PALMER CT
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-8339
Mailing Address - Country:US
Mailing Address - Phone:303-905-0994
Mailing Address - Fax:720-494-1855
Practice Address - Street 1:545 COLLYER ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-5598
Practice Address - Country:US
Practice Address - Phone:303-905-0994
Practice Address - Fax:720-494-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty