Organization
BLUE MOON BEHAVIORAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHINEKA LATOYA MACK PMHNP-BC (OWNER)
(704) 258-6720
Entity
Organization
Contact information
Practice address
199 E MONTGOMERY AVE STE 100, ROCKVILLE, MD 20850-2361
(301) 719-2913
(301) 867-5278
Mailing address
9302 WOODEN RD, RALEIGH, NC 27617-8214
(704) 258-6720
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us