Provider Demographics
NPI:1568676161
Name:ROME, ERIKA LINDSAY (BEHAVIORAL TECHNICAN)
Entity Type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:LINDSAY
Last Name:ROME
Suffix:
Gender:F
Credentials:BEHAVIORAL TECHNICAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8921 AUBREY LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-5102
Mailing Address - Country:US
Mailing Address - Phone:414-232-4158
Mailing Address - Fax:
Practice Address - Street 1:8921 AUBREY LN
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-5102
Practice Address - Country:US
Practice Address - Phone:414-232-4158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15260132101YA0400X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39174700Medicaid