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WANING MOON LLC
NPI 1467144675
Clinic/Center - Mental Health (Including Community Mental Health Center) in O Fallon, IL

Active since May 25, 2023
502 W STATE ST, O FALLON, IL 62269(217) 891-4931 Get Directions Write a Review

NPPES record last updated: May 25, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Waning Moon Llc NPPES

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

WANING MOON LLC (NPI 1467144675) is a healthcare organization registered as a mental health (including community mental health center) in O Fallon, Illinois and active in the NPI registry since May 2023. The organization lists Shelby Reece, Owner, as its authorized official.

NPPES Registry Identity

NPI1467144675
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameWANING MOON LLC
Location Address502 W STATE STO Fallon, IL 62269-1913
Mailing Address201 Blanc Lee DrBelleville, IL 62226-1526 · (217) 891-4931
Phone(217) 891-4931
Organization SubpartNo
Authorized OfficialShelby ReeceOwner · (217) 891-4931
Enumeration DateMay 25, 2023
NPPES CertifiedMay 25, 2023
✔ NPI 1467144675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
502 W STATE ST, O Fallon, IL 62269
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HARMONY HEALTH & HOME BIRTH
Advanced Practice Midwife
502 W STATE ST
O FALLON, IL 62269
St. Clair County (618) 417-7148
KACEY PANYIK APN CNM
Advanced Practice Midwife
502 W STATE ST
O FALLON, IL 62269
St. Clair County (618) 417-7148

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 Waning Moon LLC's NPI number?

The NPI number for Waning Moon LLC is 1467144675. It was assigned to this organization in the NPPES registry on May 25, 2023.

Where is Waning Moon LLC located?

Waning Moon LLC is located at 502 W State St, O Fallon, IL 62269. The listed phone number is (217) 891-4931.

What is Waning Moon 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 Waning Moon LLC was last updated on May 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.