MEDICARE: TAMMEY ROONEY LMFT PSYCHOTHERAPY, LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1710665146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMMEY ROONEY LMFT PSYCHOTHERAPY, LLC

Provider Business Mailing Address
First Line	:	33 YANKEE PEDDLER PATH
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-2615
Country	:	US
Telephone Number	:	203-530-0494
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 DURHAM RD STE 30
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-2664
Country	:	US
Telephone Number	:	203-530-0494
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAMMEY BEAN ROONEY
Credential	:	LMFT
Telephone Number	:	203-530-0494

Provider Enumeration Date	:	07/06/2023
Last Update Date	:	07/06/2023

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