# MOONRISE MENTAL HEALTH PLLC

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

## Provider details

- **NPI number:** 1720580053
- **Authorized official:** DR. SHERRY VAN METER DNP, RN, PMHNP, WHNP (OWNER)
- **Authorized official phone:** (903) 918-2123

## Contact information

- **Practice address:** 3516 NE STALLINGS DR, NACOGDOCHES, TX 75965-8732
- **Practice address phone:** (936) 564-9785
- **Practice address fax:** (936) 564-4136
- **Mailing address:** 734 COUNTY ROAD 411, GARY, TX 75643-5435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP111655 | TX | Yes |

## Other

- **Enumeration date:** 03/02/2018
- **Last updated:** 03/02/2018