Provider Demographics
NPI:1235327743
Name:ROONEY, TARA
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:ROONEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15211 UNION TPKE
Mailing Address - Street 2:CENTER FOR PSYCHOLOGICAL SERVICES
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3908
Mailing Address - Country:US
Mailing Address - Phone:516-502-2037
Mailing Address - Fax:
Practice Address - Street 1:15211 UNION TPKE
Practice Address - Street 2:CENTER FOR PSYCHOLOGICAL SERVICES
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3908
Practice Address - Country:US
Practice Address - Phone:516-502-2037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017368103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical