Provider Demographics
NPI:1043572795
Name:ROMANOW, ALEXIS (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:
Last Name:ROMANOW
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HILLSIDE ST
Mailing Address - Street 2:CORRIGAN MENTAL HEALTH CENTER
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5211
Mailing Address - Country:US
Mailing Address - Phone:508-235-7222
Mailing Address - Fax:
Practice Address - Street 1:49 HILLSIDE ST
Practice Address - Street 2:CORRIGAN MENTAL HEALTH CENTER
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5211
Practice Address - Country:US
Practice Address - Phone:508-235-7222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW 1139241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical