Provider Demographics
NPI:1265126445
Name:COONEY, DAVID J JR (LAC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:COONEY
Suffix:JR
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 COBBS MILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302-5547
Mailing Address - Country:US
Mailing Address - Phone:609-805-3632
Mailing Address - Fax:
Practice Address - Street 1:311 COBBS MILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302-5547
Practice Address - Country:US
Practice Address - Phone:609-805-3632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health