Provider Demographics
NPI:1851050926
Name:ROMANO, JESSICA (LMHC, MS)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:LMHC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E COLONIAL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4652
Mailing Address - Country:US
Mailing Address - Phone:407-777-4108
Mailing Address - Fax:
Practice Address - Street 1:708 E COLONIAL DR STE 201
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4652
Practice Address - Country:US
Practice Address - Phone:407-777-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty