Provider Demographics
NPI:1386190890
Name:MOONEY, JENNIFER J (MHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:J
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 PINEWILD DR
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-4200
Mailing Address - Country:US
Mailing Address - Phone:585-368-6700
Mailing Address - Fax:585-368-6767
Practice Address - Street 1:100 PINEWILD DR
Practice Address - Street 2:SUITE 2A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14606-4200
Practice Address - Country:US
Practice Address - Phone:585-368-6700
Practice Address - Fax:585-368-6767
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY8148207RH0003X
NYP00235101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology