Provider Demographics
NPI:1841585734
Name:MOONEY, AMY N (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:N
Last Name:MOONEY
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 WHEELER ST STE 110
Mailing Address - Street 2:BOX 380
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4367
Mailing Address - Country:US
Mailing Address - Phone:515-450-1989
Mailing Address - Fax:
Practice Address - Street 1:1103 BUCKEYE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-8120
Practice Address - Country:US
Practice Address - Phone:515-337-1380
Practice Address - Fax:855-377-6321
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00933101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional