Provider Demographics
NPI:1477764603
Name:MOONEY, ELLEN K (MA)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:K
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 S RACE ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3428
Mailing Address - Country:US
Mailing Address - Phone:610-797-5818
Mailing Address - Fax:610-797-5818
Practice Address - Street 1:402 N FULTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2002
Practice Address - Country:US
Practice Address - Phone:610-432-0521
Practice Address - Fax:610-740-9550
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health