# MOON FAMILY & BEHAVIORAL HEALTH LLC

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

## Provider details

- **NPI number:** 1902512122
- **Authorized official:** BRIAN DEAN (ADMIN)
- **Authorized official phone:** (614) 706-5206

## Contact information

- **Practice address:** 161 CLINT DR STE 200, PICKERINGTON, OH 43147-7794
- **Practice address phone:** (614) 705-6161
- **Practice address fax:** (614) 705-6151
- **Mailing address:** 161 CLINT DR STE 200, PICKERINGTON, OH 43147-7794
- **Mailing address phone:** (614) 705-6161
- **Mailing address fax:** (614) 705-6151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 01/31/2023
- **Last updated:** 01/31/2023