Provider Demographics
NPI:1962652461
Name:ROCKVILLE PSYCHOTHERAPY LCSW
Entity Type:Organization
Organization Name:ROCKVILLE PSYCHOTHERAPY LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMMELLI
Authorized Official - Suffix:
Authorized Official - Credentials:R-LCSW
Authorized Official - Phone:516-594-4408
Mailing Address - Street 1:100 N. VILLAGE AVE
Mailing Address - Street 2:SUITE 34
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570
Mailing Address - Country:US
Mailing Address - Phone:516-594-4408
Mailing Address - Fax:516-594-4408
Practice Address - Street 1:100 N. VILLAGE AVE
Practice Address - Street 2:SUITE 34
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570
Practice Address - Country:US
Practice Address - Phone:516-594-4408
Practice Address - Fax:516-594-4408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-0699201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty