Organization
HALF MOON MEDICAL ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY MOON NCC, LPC, LCAS (CLINICAL DIRECTOR)
(704) 989-1031
Entity
Organization
Contact information
Practice address
19701 W CATAWBA AVE, SUITE F, CORNELIUS, NC 28031-4080
(704) 895-7819
(704) 896-7819
Mailing address
19701 W CATAWBA AVE, SUITE F, CORNELIUS, NC 28031-4080
(704) 895-7819
(704) 896-7819
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3337
NC
101YM0800X
Mental Health Counselor
8466
NC
101YP2500X
Professional Counselor
Primary
8466
NC
207R00000X
Internal Medicine Physician
39164
NC
207RA0401X
Addiction Medicine (Internal Medicine) Physician
39164
NC
Other
Enumeration date
06/08/2014
Last updated
06/08/2014
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