Provider Demographics
NPI:1285663641
Name:ROONEY, BRUCE NICHOLAS (MSW/LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:NICHOLAS
Last Name:ROONEY
Suffix:
Gender:M
Credentials:MSW/LCSW
Other - Prefix:MR
Other - First Name:BRUCE
Other - Middle Name:NICHOLAS
Other - Last Name:ROONEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW/LCSW
Mailing Address - Street 1:3983 GARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-2362
Mailing Address - Country:US
Mailing Address - Phone:404-292-4860
Mailing Address - Fax:
Practice Address - Street 1:3983 GARFIELD DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-2362
Practice Address - Country:US
Practice Address - Phone:404-292-4860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0006711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical