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

Blue Moon Therapy LLC

Organization Mental Health Clinic/Center (Including Community Mental Health Center) · NPI 1205319472

Blue Moon Therapy LLC is a Mental Health Clinic/Center (Including Community Mental Health Center) in Wichita, Kansas. Registered with an NPI since 2018.

In the registry since
2018
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

400 N Woodlawn Ste 100
Wichita, KS 67216-1360
Phone: (316) 652-2580
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X

Record details

NPI number1205319472
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shannon Goodwin — Clinical Social Worker · (316) 249-4447
NPI enumeratedSeptember 12, 2018
Last updated in NPPESSeptember 12, 2018
Mailing address1215 E Jump St, Wichita, KS 67216-1360

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