Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blue Moon of Colorado LLC

Organization Psychologist · NPI 1629593967

Blue Moon of Colorado LLC is a Psychologist in Plainfield, Illinois. Registered with an NPI since 2017.

In the registry since
2017
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10204 Bode St Ste B
Plainfield, IL 60585-9813
Phone: (855) 241-7160
Fax: (954) 324-8354
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X
Psychologist Taxonomy 103T00000X

Record details

NPI number1629593967
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Melanie Donohue — Authorized Official · (702) 403-0438
NPI enumeratedAugust 8, 2017
Last updated in NPPESSeptember 20, 2019
Mailing address10204 Bode St Ste B, Plainfield, IL 60585-9813

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