Provider Demographics
NPI:1992373682
Name:ROONEY, RAVYN ALEXANDRIA
Entity Type:Individual
Prefix:MS
First Name:RAVYN
Middle Name:ALEXANDRIA
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 1:9550 US HIGHWAY 19 STE 202
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-4648
Mailing Address - Country:US
Mailing Address - Phone:760-972-7494
Mailing Address - Fax:
Practice Address - Street 1:2963 GULF TO BAY BLVD STE 320
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-4286
Practice Address - Country:US
Practice Address - Phone:727-241-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical