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Organization
RADIANT MOON, PLLC
Active
Organization
RADIANT MOON, PLLC
Active
Other names
Radiant Mind Wellness, Kathryn Wingard Creative Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHRYN WINGARD LCMHC, ATR-BC (OWNER/CLINICAL DIRECTOR)
(385) 346-0031
Entity
Organization
Contact information
Practice address
940 E SOUTH UNION AVE, MIDVALE, UT 84047-2302
(385) 346-0031
(385) 446-0973
Mailing address
5622 S WALDEN GLEN DR, SALT LAKE CITY, UT 84123-7925
(385) 346-0031
(385) 446-0973
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
221700000X
Art Therapist
—
NULL
221700000X
Art Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
Other
Enumeration date
10/25/2021
Last updated
12/19/2023
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