Provider Demographics
NPI:1053854356
Name:ROMANO, TAMI (CACIII)
Entity Type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:CACIII
Other - Prefix:MRS
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:TREMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CACIII
Mailing Address - Street 1:5475 MARK DABLING BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3832
Mailing Address - Country:US
Mailing Address - Phone:719-426-9450
Mailing Address - Fax:
Practice Address - Street 1:5475 MARK DABLING BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3832
Practice Address - Country:US
Practice Address - Phone:719-426-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1760-01101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
COACC.0020846OtherDIVISION OF PROFESSIONS AND OCCUPATIONS