Healthcare Provider Details

I. General information

NPI: 1750421418
Provider Name (Legal Business Name): ROBIN B ROONEY MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBIN B SMITH

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 RYAN ST STE W
BOONVILLE MO
65233-1894
US

IV. Provider business mailing address

1300 E BRADFORD PKWY
SPRINGFIELD MO
65804-4264
US

V. Phone/Fax

Practice location:
  • Phone: 660-882-7573
  • Fax:
Mailing address:
  • Phone: 417-761-5000
  • Fax: 417-761-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2014004353
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: