Robert Mooney, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180013272 Issued in IL

Practice address

3600 S Water Tower PL
Mount Vernon, IL 62864-6589

Phone

(618) 244-0212

NPI assigned

Aug 2, 2021

Last updated

Aug 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628035200000",
    "number": "1639843931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 COUNTY ROAD 1350 N",
            "city": "WAYNE CITY",
            "state": "IL",
            "postal_code": "628950420",
            "telephone_number": "618-316-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 S WATER TOWER PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646589",
            "telephone_number": "618-244-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "ROBERT",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Wilson Modert, D.O.
• Sara Kneedler Modert, D.O.
• Ahmed Salem Mohamed, MD
• Mohammed Al-Zoubaidi MD PLLC (Al-Zoubaidi Vein and Vascular center of southern Illinois)
• Shaji A Mohammed
• Judith C Morgan, RN/BA/CADC
• Mount Vernon Chiropractic Clinic
• Mount Vernon Emergency Group PC
• Mount Vernon Heart Institute LTD
• Mount Vernon Medical Enterprises Inc

• Professional Counselor in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.