Provider Demographics
NPI:1831266808
Name:ROMING, MARILYN J (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:J
Last Name:ROMING
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-6239
Mailing Address - Country:US
Mailing Address - Phone:413-841-6705
Mailing Address - Fax:
Practice Address - Street 1:14 CLIFFORD ST
Practice Address - Street 2:APT A5
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-1564
Practice Address - Country:US
Practice Address - Phone:413-841-6705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1105741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
203602OtherMHN
320781943OtherUNITED BEHAVIORAL HEALTH
720442000OtherMAGELLAN
MA000000027102OtherBMC HEALTHNET
MAP08405OtherBCBSMA
0007337538OtherAETNA
MA1852965Medicaid