Provider Demographics
NPI:1689122855
Name:ROONEY, MISTY LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:LYNN
Last Name:ROONEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3961 E CHANDLER BLVD STE 111-112
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0303
Mailing Address - Country:US
Mailing Address - Phone:480-442-3354
Mailing Address - Fax:
Practice Address - Street 1:3961 E CHANDLER BLVD STE 111-112
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0303
Practice Address - Country:US
Practice Address - Phone:480-442-3354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13742104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker