Healthcare Provider Details

I. General information

NPI: 1457283475
Provider Name (Legal Business Name): ANNA MOONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16815 S DESERT FOOTHILLS PKWY STE 134
PHOENIX AZ
85048-8465
US

IV. Provider business mailing address

16815 S DESERT FOOTHILLS PKWY STE 134
PHOENIX AZ
85048-8465
US

V. Phone/Fax

Practice location:
  • Phone: 602-550-5221
  • Fax:
Mailing address:
  • Phone: 602-550-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: