Provider Demographics
NPI:1972346088
Name:COONEY, MAXWELL
Entity type:Individual
Prefix:
First Name:MAXWELL
Middle Name:
Last Name:COONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 LOWER HAMPDEN RD
Mailing Address - Street 2:
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-9770
Mailing Address - Country:US
Mailing Address - Phone:774-823-4408
Mailing Address - Fax:
Practice Address - Street 1:275 LOWER HAMPDEN RD
Practice Address - Street 2:
Practice Address - City:MONSON
Practice Address - State:MA
Practice Address - Zip Code:01057-9770
Practice Address - Country:US
Practice Address - Phone:774-823-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health