Provider Demographics
NPI:1801804745
Name:ROMEO, LUCILLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:LUCILLE
Middle Name:
Last Name:ROMEO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021A EMMORTON RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8914
Mailing Address - Country:US
Mailing Address - Phone:410-569-3031
Mailing Address - Fax:410-569-3738
Practice Address - Street 1:2021A EMMORTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-8914
Practice Address - Country:US
Practice Address - Phone:410-569-3031
Practice Address - Fax:410-569-3738
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPO3518103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD443200200Medicaid
MDK567D890Medicare ID - Type Unspecified