Provider Demographics
NPI:1508229022
Name:ROMEO, MARIA (MLSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:ROMEO
Suffix:
Gender:F
Credentials:MLSW
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCDC
Mailing Address - Street 1:1780 ESTATES PKWY
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8002
Mailing Address - Country:US
Mailing Address - Phone:214-726-2292
Mailing Address - Fax:
Practice Address - Street 1:1780 ESTATES PKWY
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8002
Practice Address - Country:US
Practice Address - Phone:214-726-2292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
TX11708101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker