Provider Demographics
NPI:1558035212
Name:ROMINE, MARY (LSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:ROMINE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 GROSS ST APT L1
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2236
Mailing Address - Country:US
Mailing Address - Phone:812-327-6844
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD BLDG 69
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1005
Practice Address - Country:US
Practice Address - Phone:812-327-6844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138291104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker