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General NPI Number Information
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NPI Number | 1578237335
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Entity Type | Organization
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Legal Business Name | NANCY MCQUEEN MOONEY
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 95 ALLENS CREEK ROAD BUILDING 2, SUITE 17
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-633-8773
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Fax |
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Provider Business Mailing Address
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Address Line | 95 ALLENS CREEK ROAD BUILDING 2, SUITE 17
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-633-8773
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR/
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Name | NANCY MCQUEEN MOONEY
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Credential | MS ED. LMHC
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Telephone | 585-750-0594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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