| Crescent Moon Psychotherapy, Llc | |
|
2021 Bridgemill Dr Fort Mill SC 29707-9210 | |
| (313) 509-7699 | |
| Not Available |
| Full Name | Crescent Moon Psychotherapy, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2021 Bridgemill Dr, Fort Mill, South Carolina |
| Authorized Official Name and Position | Luanne Imholt (SOLE OWNER) |
| Authorized Official Contact | 3135097699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Moon Psychotherapy, Llc 1249 Ashley Creek Dr Matthews NC 28105-2442 Ph: (803) 422-3779 | Crescent Moon Psychotherapy, Llc 2021 Bridgemill Dr Fort Mill SC 29707-9210 Ph: (313) 509-7699 |
| NPI Number | 1386214245 |
|---|---|
| Provider Enumeration Date | 07/01/2021 |
| Last Update Date | 07/01/2021 |
| Certification Date | 07/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386214245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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