Provider Demographics
NPI:1427207935
Name:MOLONEY, KELLY DUNN (MA,LMHC,CMHS)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:DUNN
Last Name:MOLONEY
Suffix:
Gender:F
Credentials:MA,LMHC,CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 O AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-1753
Mailing Address - Country:US
Mailing Address - Phone:360-755-3474
Mailing Address - Fax:877-241-4344
Practice Address - Street 1:601 O AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221
Practice Address - Country:US
Practice Address - Phone:360-630-8427
Practice Address - Fax:360-899-5370
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60270951101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2095639Medicaid