Provider Demographics
NPI:1538210356
Name:ROONEY, MARY M (LCPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:M
Last Name:ROONEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N MICHIGAN
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-3502
Mailing Address - Country:US
Mailing Address - Phone:312-558-1778
Mailing Address - Fax:312-558-1779
Practice Address - Street 1:30 N MICHIGAN
Practice Address - Street 2:SUITE 1001
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3502
Practice Address - Country:US
Practice Address - Phone:312-558-1778
Practice Address - Fax:312-558-1779
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional