BLUE MOON THERAPY LLC
NPI 1205319472
Clinic/Center - Mental Health (Including Community Mental Health Center) in Wichita, KS

Q: What is Blue Moon Therapy LLC's NPI number?

The NPI number for Blue Moon Therapy LLC is 1205319472. It was assigned to this organization in the NPPES registry on September 12, 2018.

Q: What is Blue Moon Therapy LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Active since September 12, 2018

400 N WOODLAWN, SUITE 100, WICHITA, KS 67216(316) 652-2580 Get Directions Write a Review

NPPES record last updated: September 12, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Blue Moon Therapy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE MOON THERAPY LLC (NPI 1205319472) is a healthcare organization registered as a mental health (including community mental health center) in Wichita, Kansas and active in the NPI registry since September 2018. The organization lists Shannon D. Goodwin, Clinical Social Worker, as its authorized official.

NPPES Registry Identity

NPI1205319472

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameBLUE MOON THERAPY LLC

Location Address400 N WOODLAWN, SUITE 100Wichita, KS 67216-1360

Mailing Address1215 E Jump StWichita, KS 67216-1360 · (316) 249-4447

Phone(316) 652-2580

Organization SubpartNo

Authorized OfficialShannon D. GoodwinClinical Social Worker · (316) 249-4447

Enumeration DateSeptember 12, 2018

✔ NPI 1205319472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

400 N WOODLAWN, Wichita, KS 67216

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Moon Therapy LLC's NPI number?

The NPI number for Blue Moon Therapy LLC is 1205319472. It was assigned to this organization in the NPPES registry on September 12, 2018.

Where is Blue Moon Therapy LLC located?

Blue Moon Therapy LLC is located at 400 N Woodlawn Suite 100, Wichita, KS 67216. The listed phone number is (316) 652-2580.

What is Blue Moon Therapy LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Blue Moon Therapy LLC was last updated on September 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.