Provider Demographics
NPI:1851149769
Name:ROONEY, KENDRA LEIGH (LAC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:LEIGH
Last Name:ROONEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 N HAYDEN RD UNIT A207
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-4473
Mailing Address - Country:US
Mailing Address - Phone:480-262-4765
Mailing Address - Fax:
Practice Address - Street 1:7530 E ANGUS DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6410
Practice Address - Country:US
Practice Address - Phone:809-475-7394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-22817101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health