Provider Demographics
NPI:1962276014
Name:MOONEY, HAILY ROSE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:HAILY
Middle Name:ROSE
Last Name:MOONEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HAILY
Other - Middle Name:
Other - Last Name:STROEMPL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2195 OLD KENTUCKY RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-5208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2195 OLD KENTUCKY RD
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-5208
Practice Address - Country:US
Practice Address - Phone:931-644-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2224101Y00000X
FL4492101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor