Provider Demographics
NPI:1477706612
Name:ROMERO, IVONNE MARTA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:IVONNE
Middle Name:MARTA
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 1:51 OSBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-3134
Mailing Address - Country:US
Mailing Address - Phone:631-642-3351
Mailing Address - Fax:631-642-3351
Practice Address - Street 1:51 OSBORNE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-3134
Practice Address - Country:US
Practice Address - Phone:631-642-3351
Practice Address - Fax:631-642-3351
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-31
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049905-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical