Provider Demographics
NPI:1932486537
Name:ROMERO, AMY (LPC, RPT)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 SANDEST DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6515
Mailing Address - Country:US
Mailing Address - Phone:337-581-3381
Mailing Address - Fax:
Practice Address - Street 1:217 W BRENTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6110
Practice Address - Country:US
Practice Address - Phone:337-993-7927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3797101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health