Healthcare Provider Details

I. General information

NPI: 1982628285
Provider Name (Legal Business Name): ROBERT LAWRENCE ROONEY MA L.C.P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8203 HARFORD RD
PARKVILLE MD
21234-5888
US

IV. Provider business mailing address

1905 PATRICIA CT
WESTMINSTER MD
21158-2713
US

V. Phone/Fax

Practice location:
  • Phone: 800-491-5369
  • Fax:
Mailing address:
  • Phone: 410-857-1297
  • Fax: 410-857-1865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberLC2222
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: