# BLACK LIGHT THERAPY, LLC

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

## Provider details

- **NPI number:** 1710832704
- **Authorized official:** RHONDA ELAINE MOORE (MANAGING MEMBER)
- **Authorized official phone:** (425) 876-2681

## Contact information

- **Practice address:** 1307 SAINT PAUL STREET, SECOND FLOOR, SUITE E, BALTIMORE, MD 21202-2712
- **Practice address phone:** (425) 876-2681
- **Mailing address:** 1307 SAINT PAUL STREET, SECOND FLOOR, SUITE E, BALTIMORE, MD 21202-2712
- **Mailing address phone:** (425) 876-2681

## Taxonomy

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

## Other

- **Enumeration date:** 03/04/2026
- **Last updated:** 06/11/2026