Provider Demographics
NPI:1841450954
Name:ROME, FERN (LCSW)
Entity type:Individual
Prefix:MS
First Name:FERN
Middle Name:
Last Name:ROME
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 W SADDLE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2620
Mailing Address - Country:US
Mailing Address - Phone:201-882-2535
Mailing Address - Fax:
Practice Address - Street 1:19 SPEAR RD
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1235
Practice Address - Country:US
Practice Address - Phone:201-882-2535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053425001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical