Provider Demographics
NPI:1578237335
Name:NANCY MCQUEEN MOONEY
Entity type:Organization
Organization Name:NANCY MCQUEEN MOONEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR/
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:MCQUEEN
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED LMHC
Authorized Official - Phone:585-750-0594
Mailing Address - Street 1:95 ALLENS CREEK ROAD
Mailing Address - Street 2:BUILDING 2, SUITE 17
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-633-8773
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK ROAD
Practice Address - Street 2:BUILDING 2, SUITE 17
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-633-8773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty