Provider Demographics
NPI:1245935766
Name:MOONEY, JULIA (LMSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MOONEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3553 77TH ST APT 6F
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-4538
Mailing Address - Country:US
Mailing Address - Phone:917-887-0847
Mailing Address - Fax:
Practice Address - Street 1:330 W 38TH ST RM 705
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-2515
Practice Address - Country:US
Practice Address - Phone:347-674-0773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1172961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical