MEDICARE: RONEY'S PLACE A LICENSED CLINICAL SOCIAL WORKER CORPORATION

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1528921582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONEY'S PLACE A LICENSED CLINICAL SOCIAL WORKER CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 3215
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90408-3215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1402 ARIZONA AVE APT 8
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-1029
Country	:	US
Telephone Number	:	818-590-1349
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROOHINEE SANTRAM
Credential	:	LCSW
Telephone Number	:	818-590-1349

Provider Enumeration Date	:	12/06/2025
Last Update Date	:	12/06/2025

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