| Moonstone Therapy And Wellness | |
|
475 Wall St Princeton NJ 08540-1509 | |
| (609) 213-0128 | |
| Not Available |
| Full Name | Moonstone Therapy And Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 475 Wall St, Princeton, New Jersey |
| Authorized Official Name and Position | Shanya Roberson (OWNER) |
| Authorized Official Contact | 6092130128 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonstone Therapy And Wellness 475 Wall St Princeton NJ 08540-1509 Ph: (609) 213-0128 | Moonstone Therapy And Wellness 475 Wall St Princeton NJ 08540-1509 Ph: (609) 213-0128 |
| NPI Number | 1124855945 |
|---|---|
| Provider Enumeration Date | 09/16/2024 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 5890226724 |
|---|---|
| Medicare Enrollment ID | O20241003000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124855945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Shanya Roberson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851968242 PECOS PAC ID: 2466819198 Enrollment ID: I20230612000274 |
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