Provider Demographics
NPI:1346624079
Name:MOONEY, BARBARA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:MOONEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37862-3816
Mailing Address - Country:US
Mailing Address - Phone:678-897-9603
Mailing Address - Fax:865-774-4235
Practice Address - Street 1:419 HIGH ST
Practice Address - Street 2:
Practice Address - City:SEVIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37862-3816
Practice Address - Country:US
Practice Address - Phone:678-897-9603
Practice Address - Fax:865-774-4235
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN62381041C0700X
GACSW0032581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical