Provider Demographics
NPI:1730467952
Name:MOONEY, ANDREA R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:R
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 1:79 LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:ME
Mailing Address - Zip Code:04345-5970
Mailing Address - Country:US
Mailing Address - Phone:207-558-5982
Mailing Address - Fax:
Practice Address - Street 1:79 LANCASTER RD
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:ME
Practice Address - Zip Code:04345-5970
Practice Address - Country:US
Practice Address - Phone:207-558-5982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC144801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical