Provider Demographics
NPI:1891915237
Name:ROONEY, ALICE HUNT (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:HUNT
Last Name:ROONEY
Suffix:
Gender:F
Credentials:MSW
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 1231
Mailing Address - Street 2:
Mailing Address - City:WRANGELL
Mailing Address - State:AK
Mailing Address - Zip Code:99929-1231
Mailing Address - Country:US
Mailing Address - Phone:907-874-3375
Mailing Address - Fax:907-874-3339
Practice Address - Street 1:ALASKA ISLAND COMMUNITY SERVICES
Practice Address - Street 2:333 CHURCH STREET
Practice Address - City:WRANGELL
Practice Address - State:AK
Practice Address - Zip Code:99929-1231
Practice Address - Country:US
Practice Address - Phone:907-874-3375
Practice Address - Fax:907-874-3339
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM4301Medicaid