Provider Demographics
NPI:1003084161
Name:MOONEY, THOMAS FRANCIS (EDD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCIS
Last Name:MOONEY
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 62ND SE
Mailing Address - Street 2:
Mailing Address - City:SAUGATUCK
Mailing Address - State:MI
Mailing Address - Zip Code:49453-9701
Mailing Address - Country:US
Mailing Address - Phone:616-666-1510
Mailing Address - Fax:866-752-2359
Practice Address - Street 1:3206 62ND SE
Practice Address - Street 2:
Practice Address - City:SAUGATUCK
Practice Address - State:MI
Practice Address - Zip Code:49453-9701
Practice Address - Country:US
Practice Address - Phone:616-666-1510
Practice Address - Fax:866-752-2359
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301001704103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral