Provider Demographics
NPI:1821146358
Name:ROMERO, KAREN E (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:E
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:
Mailing Address - City:TOME
Mailing Address - State:NM
Mailing Address - Zip Code:87060
Mailing Address - Country:US
Mailing Address - Phone:505-269-2816
Mailing Address - Fax:
Practice Address - Street 1:343 MAIN ST NW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031
Practice Address - Country:US
Practice Address - Phone:505-866-8340
Practice Address - Fax:505-866-2180
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-08-20
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-08-20
Provider Licenses
StateLicense IDTaxonomies
NMM05716104100000X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM90631242Medicaid