Organization · Type 2 NPI
Crescent Moon Awakening
Mental Health Counselor · Russellville, AR
NPI number
1316804891
Active
Practice location
307 James Cir
Russellville, AR 72801-5829
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
Another provider at this address
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About NPI 1316804891
Crescent Moon Awakening's National Provider Identifier is 1316804891, issued on Jan 7, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Russellville, AR. The record was last updated on Jan 7, 2026.