Blue Moon of Colorado LLC
NPI 1629593967 · Clinical Social Worker · Plainfield, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Blue Moon of Colorado LLC is a Clinical Social Worker organization in Plainfield, IL (NPI 1629593967).
Provider details
- NPI number
- 1629593967
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Melanie Donohue, Authorized Official(702) 403-0438
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Psychologist103T00000X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2017-08-08
- Last updated
- 2019-09-20
Frequently asked questions
- What is Blue Moon of Colorado LLC's NPI number?
- Blue Moon of Colorado LLC's National Provider Identifier (NPI) is 1629593967, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Blue Moon of Colorado LLC?
- Blue Moon of Colorado LLC is classified in the NPPES registry as Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Blue Moon of Colorado LLC located?
- Blue Moon of Colorado LLC's practice location on file with NPPES is 10204 Bode St Ste B, Plainfield, IL 60585-9813.
- What is Blue Moon of Colorado LLC's phone number?
- The practice phone number listed in the NPPES registry for Blue Moon of Colorado LLC is (855) 241-7160.
- Does Blue Moon of Colorado LLC accept Medicare?
- Blue Moon of Colorado LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Blue Moon of Colorado LLC?
- The authorized official listed on Blue Moon of Colorado LLC's NPPES record is Melanie Donohue, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Blue Moon of Colorado LLC's NPI active?
- Yes — Blue Moon of Colorado LLC's NPI (1629593967) is active in the NPPES registry as of the last update on 2019-09-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.