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Organization
MOON RISING LLC
Active
Organization
MOON RISING LLC
Active
Other names
Moon Rising, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA WALLS (OWNER)
(850) 270-7295
Entity
Organization
Contact information
Practice address
1300 N PALAFOX ST STE 102C, PENSACOLA, FL 32501-2678
(850) 270-7295
Mailing address
382 NE 191ST ST, MIAMI, FL 33179-3899
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
01/08/2025
Last updated
06/02/2026
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