Healthcare Provider Details

I. General information

NPI: 1295994135
Provider Name (Legal Business Name): STEPHEN CRAIG ROONEY PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD DRIVE BOX 706
ROCHESTER NY
14642-0001
US

IV. Provider business mailing address

601 ELMWOOD DRIVE BOX 706
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-7301
  • Fax: 585-742-4215
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2008014044
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number026629
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2008014044
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number026629
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: