# BLUE MOON COUNSELING PLLC

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

## Provider details

- **NPI number:** 1598589822
- **Authorized official:** JESSICA DOPHEIDE (OWNER)
- **Authorized official phone:** (641) 840-0813

## Contact information

- **Practice address:** 939 OFFICE PARK RD STE 310, WEST DES MOINES, IA 50265-2538
- **Practice address phone:** (641) 840-0813
- **Mailing address:** 9225 LINCOLN AVE, CLIVE, IA 50325-6261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2024
- **Last updated:** 11/13/2024