Organization
MOONPHASE INTEGRATIVE PSYCHIATRY & WELLNESS, PLLC
Active
Other names
MoonPhase Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE WHITAKER MSN, APRN,PMHNP-BC (OWNER, MANAGING MBR)
(508) 566-4032
Entity
Organization
Contact information
Practice address
20 CABOT BLVD STE 300, MANSFIELD, MA 02048-1183
(508) 690-0688
Mailing address
235 MANCHAUG RD, SUTTON, MA 01590-1647
(339) 215-8115
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/11/2026
Last updated
06/11/2026
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