Provider Demographics
NPI:1194021311
Name:ROOZEN, MARNIE R (LPC)
Entity Type:Individual
Prefix:
First Name:MARNIE
Middle Name:R
Last Name:ROOZEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 833
Mailing Address - Street 2:
Mailing Address - City:QUEEN CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75572-0833
Mailing Address - Country:US
Mailing Address - Phone:903-244-5341
Mailing Address - Fax:903-255-0310
Practice Address - Street 1:107 WOODBINE PL
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-2912
Practice Address - Country:US
Practice Address - Phone:903-831-7585
Practice Address - Fax:903-234-1639
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-05
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62565101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health