# MOONPHASE INTEGRATIVE PSYCHIATRY & WELLNESS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MoonPhase Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871427021
- **Authorized official:** MICHELE WHITAKER MSN, APRN,PMHNP-BC (OWNER, MANAGING MBR)
- **Authorized official phone:** (508) 566-4032

## Contact information

- **Practice address:** 20 CABOT BLVD STE 300, MANSFIELD, MA 02048-1183
- **Practice address phone:** (508) 690-0688
- **Mailing address:** 235 MANCHAUG RD, SUTTON, MA 01590-1647
- **Mailing address phone:** (339) 215-8115

## Taxonomy

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

## Other

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