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

Crescent Moon Psychiatry LLC

Organization Psychiatric/Mental Health Nurse Practitioner · NPI 1063392934

Crescent Moon Psychiatry LLC is a Psychiatric/Mental Health Nurse Practitioner in Fort Collins, Colorado. Registered with an NPI since 2025.

In the registry since
2025
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

1302 S Shields St Ste A1-2
Fort Collins, CO 80521-4801
Phone: (970) 427-2820
Fax: (970) 585-8169
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X

Record details

NPI number1063392934
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Miranda — Owner · (970) 427-2820
NPI enumeratedSeptember 3, 2025
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025
Mailing address1302 S Shields St Ste A1-2, Fort Collins, CO 80521-4801

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