| Moonlight Trauma And Counseling Center Pllc | |
|
3125 Village Office Pl Champaign IL 61822-7673 | |
| (217) 419-1878 | |
| Not Available |
| Full Name | Moonlight Trauma And Counseling Center Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3125 Village Office Pl, Champaign, Illinois |
| Authorized Official Name and Position | Deidre Dame (LCSW) |
| Authorized Official Contact | 2174191878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Moonlight Trauma And Counseling Center Pllc 3125 Village Office Pl Champaign IL 61822-7673 Ph: () - | Moonlight Trauma And Counseling Center Pllc 3125 Village Office Pl Champaign IL 61822-7673 Ph: (217) 419-1878 |
| NPI Number | 1740134485 |
|---|---|
| Provider Enumeration Date | 02/20/2026 |
| Last Update Date | 02/20/2026 |
| Certification Date | 02/20/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740134485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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