Organization
MOONLIGHT MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN JOHNSON LPC-S (OWNER)
(501) 278-1736
Entity
Organization
Contact information
Practice address
211 S MAIN, BENTON, AR 72015-4331
(662) 727-1053
(501) 214-6867
Mailing address
208 E RICHARDSON PLACE DR, BRYANT, AR 72022-3246
(501) 278-1736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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