Provider Demographics
NPI:1245847391
Name:MOONEY, JOSEPH (LCSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MOONEY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 E LINCOLN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-6406
Mailing Address - Country:US
Mailing Address - Phone:309-948-6999
Mailing Address - Fax:309-451-9404
Practice Address - Street 1:705 E LINCOLN ST STE 303
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-6406
Practice Address - Country:US
Practice Address - Phone:309-948-6999
Practice Address - Fax:309-451-9404
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149025305101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health