Provider Demographics
NPI:1912365834
Name:MOONEY, BRIGID ROCHE (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIGID
Middle Name:ROCHE
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 1:7031 S ASH CIR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2184
Mailing Address - Country:US
Mailing Address - Phone:720-785-4480
Mailing Address - Fax:
Practice Address - Street 1:609 W LITTLETON BLVD
Practice Address - Street 2:STE 309
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2368
Practice Address - Country:US
Practice Address - Phone:720-785-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical