Provider Demographics
NPI:1336228741
Name:MOONEY, SHEILA F (MA)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:F
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:SWOYERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18704-1929
Mailing Address - Country:US
Mailing Address - Phone:570-899-0602
Mailing Address - Fax:570-824-1408
Practice Address - Street 1:65 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-3100
Practice Address - Country:US
Practice Address - Phone:570-822-9706
Practice Address - Fax:570-824-1408
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004597L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist