Provider Demographics
NPI:1831671163
Name:ROMANO, SANDRA O (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:O
Last Name:ROMANO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 JAMES TRL
Mailing Address - Street 2:
Mailing Address - City:WEST KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02892-1703
Mailing Address - Country:US
Mailing Address - Phone:401-783-0964
Mailing Address - Fax:
Practice Address - Street 1:160 JAMES TRL
Practice Address - Street 2:
Practice Address - City:WEST KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02892-1703
Practice Address - Country:US
Practice Address - Phone:401-783-0964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110172-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical