Provider Demographics
NPI:1417196890
Name:ROMIG, LIBERTY MICHAEL (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LIBERTY
Middle Name:MICHAEL
Last Name:ROMIG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1556
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465
Mailing Address - Country:US
Mailing Address - Phone:805-610-7444
Mailing Address - Fax:805-434-9474
Practice Address - Street 1:318 CROCKER STREET
Practice Address - Street 2:
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465
Practice Address - Country:US
Practice Address - Phone:805-610-7444
Practice Address - Fax:805-434-9474
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45168106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist