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General NPI Number Information
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NPI Number | 1932102308
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Entity Type | Organization
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Legal Business Name | MICHAEL MOONEY, INC
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 27700 GRATIOT AVE STE 202
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City | ROSEVILLE
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State | MI
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Zip | 48066-4880
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Country | US
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Telephone | 586-350-6800
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Fax | 586-772-5102
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Provider Business Mailing Address
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Address Line | 27730 GRATIOT AVE
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City | ROSEVILLE
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State | MI
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Zip | 48066-4838
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Country | US
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Telephone | 586-772-5101
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Fax | 586-772-5102
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MR. MICHAEL JOSEPH MOONEY
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Credential | MA, LLP, CAC-II, CCS
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Telephone | 586-772-5101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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