Provider Demographics
NPI:1245471390
Name:ROMANO, LORI ROSE (PHD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ROSE
Last Name:ROMANO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:LEHR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:833 CHESTNUT STREET EAST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4405
Practice Address - Country:US
Practice Address - Phone:215-861-8830
Practice Address - Fax:215-861-8833
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 15096103T00000X
PAPSO15096103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103T00000XBehavioral Health & Social Service ProvidersPsychologist