Organization · Type 2 NPI

Blue Moon of Colorado LLC

Clinical Social Worker · Plainfield, IL

NPI number 1629593967 Active

Practice location

10204 Bode St Ste B
Plainfield, IL 60585-9813

Call (855) 241-7160 Map

Fax (954) 324-8354

Specialties and licenses

TaxonomyCodeLicense
Psychologist 103T00000XNone listed
Clinical Social Worker Primary 1041C0700XNone listed

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1629593967

Blue Moon of Colorado LLC's National Provider Identifier is 1629593967, issued on Aug 8, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Plainfield, IL. The record was last updated on Sep 20, 2019.