Healthcare Provider Details
I. General information
NPI: 1396973392
Provider Name (Legal Business Name): BRANDON P ROMANO PSYD & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10211 SIEGEN LN STE 2A
BATON ROUGE LA
70810-4988
US
IV. Provider business mailing address
10211 SIEGEN LN STE 2A
BATON ROUGE LA
70810-4926
US
V. Phone/Fax
- Phone: 225-769-2533
- Fax: 225-769-2441
- Phone: 225-769-2533
- Fax: 225-769-2441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 977 |
| License Number State | LA |
VIII. Authorized Official
Name: DR.
BRANDON
P.
ROMANO
Title or Position: OWNER / CLINICAL PSYCHOLOGIST
Credential: PSY.D., MSCP
Phone: 225-769-2533