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Individual

MRS. INDIA R MOONEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
12200 E 13 MILE RD, WARREN, MI 48093-3093
(313) 255-8250
Mailing address
4410 W 13 MILE RD, ROYAL OAK, MI 48073-6515
(313) 255-8267
(313) 242-0490

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401019217
MI
101YM0800X
Mental Health Counselor
6401019217
MI
101YM0800X
Mental Health Counselor
Primary
6401223867
MI
101YP2500X
Professional Counselor
6401019217
MI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6344
MI
Enumeration date
08/27/2019
Last updated
01/22/2024
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