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NICOLE MOON
NPI 1972220333
Counselor - Mental Health in Roseburg, OR

Active since October 25, 2022
548 SE JACKSON ST, ROSEBURG, OR 97470(541) 672-2691 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 17, 2024, Oct 25, 2022 (2 updates tracked since 2022).

About Nicole Moon NPPES

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

NICOLE MOON (NPI 1972220333) is an individual mental health provider in Roseburg, Oregon and active in the NPI registry since October 2022.

NPPES Registry Identity

NPI1972220333
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNICOLE MOON
Location Address548 SE JACKSON STRoseburg, OR 97470-4983
Mailing AddressPo Box 1121Roseburg, OR 97470-0254 · (541) 672-2691
Phone(541) 672-2691
Sole ProprietorNo
Enumeration DateOctober 25, 2022
Last NPPES UpdateApril 17, 20252 updates tracked since enumeration
NPPES CertifiedApril 17, 2025
✔ NPI 1972220333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedPeer SpecialistTaxonomy 175T00000X
548 SE JACKSON ST, Roseburg, OR 97470
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Other Providers at the Same Location NPPES 19

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

ALLAN RAY SPRINGER B.S.
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
KRISTINE ELIZABETH PETERMAN
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MR. WILLIE DIEAGO HAABY B.S., CADC I
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MRS. TINA LOUISE MARLOW CADC I
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MR. ROBERT LEON JASPERSON CADC II
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MRS. ERIN ANDREA DELCOLLO CADCI
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MS. JANICE LEE CUMMINS CADC I
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691
MS. GLENDA JOYCE MAJOR CADC III LPT.
Counselor (Addiction (Substance Use Disorder))
548 SE JACKSON ST
ROSEBURG, OR 97470
Douglas County (541) 672-2691

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 Nicole Moon's NPI number?

The NPI number for Nicole Moon is 1972220333. It was assigned to this individual provider in the NPPES registry on October 25, 2022.

Where is Nicole Moon located?

Nicole Moon practices at 548 SE Jackson St, Roseburg, OR 97470. The listed phone number is (541) 672-2691.

What is Nicole Moon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Nicole Moon was last updated on April 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.