Organization
FULL MOON WELLNESS AND CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE HIGGASON LCSW (OWNER/LCSW)
(720) 250-7911
Entity
Organization
Contact information
Practice address
7155 SW VARNS ST STE 215, PORTLAND, OR 97223-8175
(503) 894-7144
Mailing address
7155 SW VARNS ST STE 215, PORTLAND, OR 97223-8175
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
10/30/2024
Last updated
08/18/2025
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