Provider Demographics
NPI:1508346669
Name:ABAWI-WOOTEN, ROMINA (MA, CSAC, NCC)
Entity Type:Individual
Prefix:
First Name:ROMINA
Middle Name:
Last Name:ABAWI-WOOTEN
Suffix:
Gender:F
Credentials:MA, CSAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 PROFESSIONAL DR STE K
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-6618
Mailing Address - Country:US
Mailing Address - Phone:703-498-8675
Mailing Address - Fax:
Practice Address - Street 1:1158 PROFESSIONAL DR STE K
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-6618
Practice Address - Country:US
Practice Address - Phone:703-498-8675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2021-03-24
Deactivation Date:2021-02-10
Deactivation Code:
Reactivation Date:2021-03-17
Provider Licenses
StateLicense IDTaxonomies
VA0710102735101YA0400X
VA0701008810101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)