Provider Demographics
NPI:1659408557
Name:ROMEO, ALLEN JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:JOSEPH
Last Name:ROMEO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 MOUNTAIN AIRE DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28678-9182
Mailing Address - Country:US
Mailing Address - Phone:704-585-9606
Mailing Address - Fax:
Practice Address - Street 1:1706 DAVIE AVE
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3589
Practice Address - Country:US
Practice Address - Phone:704-872-5990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2010-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2207103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000330Medicaid
NC03987OtherBCBS OF NC NUMBER
NC6000330Medicaid