Provider Demographics
NPI:1659423663
Name:ROMERO, ROXANNE RACHEAL (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:RACHEAL
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 CERRO PARRIDO RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-8957
Mailing Address - Country:US
Mailing Address - Phone:505-617-4691
Mailing Address - Fax:505-766-9157
Practice Address - Street 1:707 BROADWAY BLVD NE STE 103
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2300
Practice Address - Country:US
Practice Address - Phone:505-766-9361
Practice Address - Fax:505-766-9157
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0075631101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health