Provider Demographics
NPI:1174330443
Name:ROMAN COUNSELING AND CONSULTATION, LLC
Entity type:Organization
Organization Name:ROMAN COUNSELING AND CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-837-1943
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:
Mailing Address - City:SOUTH GARDINER
Mailing Address - State:ME
Mailing Address - Zip Code:04359-0215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:671 RIVER AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GARDINER
Practice Address - State:ME
Practice Address - Zip Code:04359-3001
Practice Address - Country:US
Practice Address - Phone:207-837-1943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty