Provider Demographics
NPI:1083254122
Name:WONEY, EBONY DELORIS (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:EBONY
Middle Name:DELORIS
Last Name:WONEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BAYCHESTER AVE APT 19F
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-1715
Mailing Address - Country:US
Mailing Address - Phone:347-420-8267
Mailing Address - Fax:
Practice Address - Street 1:900 BAYCHESTER AVE APT 19F
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-1715
Practice Address - Country:US
Practice Address - Phone:347-420-8267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008836101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional