Organization
CRESCENT MOON AWAKENING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAZEL MOON MS LPC (OWNER)
(479) 880-3682
Entity
Organization
Contact information
Practice address
307 JAMES CIR, RUSSELLVILLE, AR 72801-5829
(479) 880-3682
Mailing address
307 JAMES CIR, RUSSELLVILLE, AR 72801-5829
(479) 880-3682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/07/2026
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