Provider Demographics
NPI:1649386780
Name:CIRILLO-ROMANIELLO, DENISE BLAINE (MSW LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:BLAINE
Last Name:CIRILLO-ROMANIELLO
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 PHEASANT LANE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CO
Mailing Address - Zip Code:06468
Mailing Address - Country:US
Mailing Address - Phone:203-257-4185
Mailing Address - Fax:203-268-0351
Practice Address - Street 1:88 TRAP FALLS ROAD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4649
Practice Address - Country:US
Practice Address - Phone:203-257-4185
Practice Address - Fax:203-264-0351
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0045551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical