Provider Demographics
NPI:1992379549
Name:ROMAGNUOLO, GENNA MARIE (LMHC)
Entity Type:Individual
Prefix:
First Name:GENNA
Middle Name:MARIE
Last Name:ROMAGNUOLO
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 1:521 NORTHLAKE BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-5418
Mailing Address - Country:US
Mailing Address - Phone:561-421-4104
Mailing Address - Fax:
Practice Address - Street 1:521 NORTHLAKE BLVD STE 6
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-5418
Practice Address - Country:US
Practice Address - Phone:561-421-4104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15626101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty