BLUE MOON OF COLORADO LLC - NPI 1629593967 - Social Worker in Plainfield, IL

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

The NPI number for Blue Moon Of Colorado LLC is 1629593967. It was assigned to this organization in the NPPES registry on August 8, 2017.

Q: What is Blue Moon Of Colorado LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

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About Blue Moon Of Colorado Llc NPPES

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

BLUE MOON OF COLORADO LLC (NPI 1629593967) is a healthcare organization registered as a clinical in Plainfield, Illinois and active in the NPI registry since August 2017. The organization lists Melanie Donohue, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1629593967

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameBLUE MOON OF COLORADO LLC

Location Address10204 BODE ST STE BPlainfield, IL 60585-9813

Mailing Address10204 Bode St Ste BPlainfield, IL 60585-9813 · (855) 241-7160 · Fax (954) 324-8354

Phone(855) 241-7160

Fax(954) 324-8354

Organization SubpartNo

Authorized OfficialMelanie DonohueAuthorized Official · (702) 403-0438

Enumeration DateAugust 8, 2017

Last NPPES UpdateSeptember 20, 20192 updates tracked since enumeration

✔ NPI 1629593967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedPsychologistTaxonomy 103T00000X

10204 BODE ST STE B, Plainfield, IL 60585

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 16

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

VIKTORIJA BENNETT

Social Worker (Clinical)