Provider Demographics
NPI:1164143848
Name:ROMERO, GUADALUPE (LCSW)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15331 W BELL RD STE 212
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4104
Mailing Address - Country:US
Mailing Address - Phone:623-692-7380
Mailing Address - Fax:
Practice Address - Street 1:15331 W BELL RD STE 212
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4104
Practice Address - Country:US
Practice Address - Phone:623-692-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-204051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical