Healthcare Provider Details

I. General information

NPI: 1346017662
Provider Name (Legal Business Name): MICHELLE LEE ROMERO MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICAH ROMERO MA, LPC

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-1814
US

IV. Provider business mailing address

1324 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA
70506-1814
US

V. Phone/Fax

Practice location:
  • Phone: 337-366-6118
  • Fax:
Mailing address:
  • Phone: 337-366-6118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9183
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: