Provider Demographics
NPI:1104941210
Name:ROONEY, KATHLEEN (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ROONEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PINETOWN RD
Mailing Address - Street 2:STE 210
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2605
Mailing Address - Country:US
Mailing Address - Phone:215-643-0200
Mailing Address - Fax:215-643-9844
Practice Address - Street 1:550 PINETOWN RD
Practice Address - Street 2:STE 210
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-2605
Practice Address - Country:US
Practice Address - Phone:215-643-0200
Practice Address - Fax:215-643-9844
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7189775OtherAETNA
PA2633566000OtherKEYSTONE HEALTH PLAN EAST
PA2633566000OtherPERSONAL CHOICE