Provider Demographics
NPI:1891017471
Name:ROMERO, MICHELLE J (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:J
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CARNATION AVE
Mailing Address - Street 2:BUILDING ONE, 2ND FLOOR
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1705
Mailing Address - Country:US
Mailing Address - Phone:917-327-4541
Mailing Address - Fax:718-473-2930
Practice Address - Street 1:50 CARNATION AVE
Practice Address - Street 2:BUILDING ONE, 2ND FLOOR
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1705
Practice Address - Country:US
Practice Address - Phone:917-327-4541
Practice Address - Fax:718-473-2930
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0798161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical