Provider Demographics
NPI:1811401896
Name:ROBERT ROMANO, LCSW, LLC
Entity Type:Organization
Organization Name:ROBERT ROMANO, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-654-9094
Mailing Address - Street 1:49 WEBB AVE
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4410
Mailing Address - Country:US
Mailing Address - Phone:203-856-2574
Mailing Address - Fax:203-263-9713
Practice Address - Street 1:30 OLD KINGS HWY S
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4551
Practice Address - Country:US
Practice Address - Phone:203-654-9094
Practice Address - Fax:203-263-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0096921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008073043Medicaid