Provider Demographics
NPI:1780409607
Name:NEW MOON PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:NEW MOON PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOON
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:828-484-1801
Mailing Address - Street 1:558 FLEMING ST STE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4216
Mailing Address - Country:US
Mailing Address - Phone:828-484-1801
Mailing Address - Fax:
Practice Address - Street 1:770 WATER ST STE 457
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4220
Practice Address - Country:US
Practice Address - Phone:828-484-1801
Practice Address - Fax:877-349-6373
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW MOON PSYCHIATRY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-15
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)