Provider Demographics
NPI:1396260337
Name:MOONEY, STEPHANIE LYNNE
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:MOONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 INKBERRY RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19057-2217
Mailing Address - Country:US
Mailing Address - Phone:215-815-4345
Mailing Address - Fax:
Practice Address - Street 1:43 INKBERRY RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-2217
Practice Address - Country:US
Practice Address - Phone:215-815-4345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health