Provider Demographics
NPI:1992041982
Name:ROMAN, ANN TAYLOR (LMHC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:TAYLOR
Last Name:ROMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 JULIA PL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-6913
Mailing Address - Country:US
Mailing Address - Phone:941-735-4975
Mailing Address - Fax:
Practice Address - Street 1:315 JULIA PL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-6913
Practice Address - Country:US
Practice Address - Phone:941-735-4975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health