Moon River, Llc is a Psychology Clinic in Marietta, Georgia. It is located at 790 Oak Trail Dr, Marietta, GA and its contact number is 770-977-6866. The authorized person for Moon River, Llc is Laura Desantis
who is Office Manager of the clinic and his/her contact number is 770-212-2170. Moon River, Llc Clinic is specialized in psychological testing and evaluating or assessing patient's personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning. Accordingly, psychologists performs counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy. Psychologists can diagnose and treat mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability by psycheducational evaluation, therapy, remediation, and consultation.
Complete Clinic Profile:
Moon River, Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Moon River, Llc
Specialization:
Psychology
Clinic Address:
790 Oak Trail Dr, Marietta, Georgia, 30062-7502
Phone:
770-977-6866
Fax:
770-977-6887
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Laura Desantis
Position:
Office Manager
Contact Number:
770-212-2170
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Moon River, Llc clinic are as mentioned below.
NPI Number:
1730143553
NPI Enumeration Date:
17 Apr, 2006
NPI Last Update On:
18 Feb, 2025
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Moon River, Llc are as mentioned below.
Specialization
License Number
State
Status
Behavioral Analyst
Primary
Psychologist
Secondary
Physical Therapist
PT003833
Georgia
Secondary
Pediatrics
OT 004293
Georgia
Secondary
Pediatrics
GAOT001717
Georgia
Secondary
Speech-language Pathologist
SLP003992
Georgia
Secondary
Speech-language Pathologist
SLP005806
Georgia
Secondary
Speech-language Pathologist
SLP006528
Georgia
Secondary
Speech-language Pathologist
SLP 06551
Georgia
Secondary
Speech-language Pathologist
SLP 006556
Georgia
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
000970835A
Medicaid
Georgia
317872221A
Medicaid
Georgia
503885675B
Medicaid
Georgia
315889908A
Medicaid
Georgia
339518223A
Medicaid
Georgia
516643175A
Medicaid
Georgia
761415888A
Medicaid
Georgia
765677599A
Medicaid
Georgia
814363142A
Medicaid
Georgia
188883028B
Medicaid
Georgia
426315361A
Medicaid
Georgia
000753563E
Medicaid
Georgia
191707573A
Medicaid
Georgia
461168837A
Medicaid
Georgia
481436178B
Medicaid
Georgia
000860736B
Medicaid
Georgia
240960806A
Medicaid
Georgia
850524466A
Medicaid
Georgia
146855825A
Medicaid
Georgia
986209149B
Medicaid
Georgia
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Moon River, Llc 790 Oak Trail Dr, Marietta, Georgia
Zip:
30062-7502
Phone Number:
770-212-2170
Fax Number:
770-783-8639
Patients can reach Moon River, Llc at 790 Oak Trail Dr, Marietta, Georgia or can call to book an appointment on 770-977-6866. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 April, 2025.