# HALF MOON MENTAL HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073294062
- **Authorized official:** ALEXIS ENTERLINE LCSW (OWNER)
- **Authorized official phone:** (702) 234-2926

## Contact information

- **Practice address:** 4955 S DURANGO DR STE 157, LAS VEGAS, NV 89113-0154
- **Practice address phone:** (702) 234-2926
- **Mailing address:** 7236 BOYD LN, LAS VEGAS, NV 89131-2502
- **Mailing address phone:** (702) 234-2926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2023
- **Last updated:** 08/16/2023