Provider Demographics
NPI:1457556623
Name:MOONEY, VALERIE DEVRIES (LPC)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:DEVRIES
Last Name:MOONEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1448 DIAMOND HEAD CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2304
Mailing Address - Country:US
Mailing Address - Phone:404-228-6202
Mailing Address - Fax:770-761-6595
Practice Address - Street 1:999 GREEN ST SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-5405
Practice Address - Country:US
Practice Address - Phone:770-761-9959
Practice Address - Fax:770-761-6595
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2376101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional