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NPI Code Detail

MEDICARE: PATRICK MICHAEL ROOKEY LICSW

MEDICARE: PATRICK MICHAEL ROOKEY LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerMN

General Provider Information

NPI Number : 1194106252
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK MICHAEL ROOKEY LICSW
Provider Business Mailing Address
First Line : 1516 W LAKE ST
Second Line : 110
City : MINNEAPOLIS
State : MN
Zip : 55408-2554
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2712 FREMONT AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55408-1122
Country : US
Telephone Number : 612-872-8218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2015
Last Update Date : 06/15/2015

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Directions to “ PATRICK MICHAEL ROOKEY LICSW” Practice Location

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