Provider Demographics
NPI:1821652322
Name:ROONEY-MALKY, THERESA MADELINE (MA, NCC, LPC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MADELINE
Last Name:ROONEY-MALKY
Suffix:
Gender:
Credentials:MA, NCC, LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 HARBOR SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-4502
Mailing Address - Country:US
Mailing Address - Phone:727-210-5828
Mailing Address - Fax:
Practice Address - Street 1:523 HARBOR SPRINGS DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683-4502
Practice Address - Country:US
Practice Address - Phone:727-210-5828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-30
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH24347101YP2500X
PAPC015595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional