Healthcare Provider Details

I. General information

NPI: 1619310794
Provider Name (Legal Business Name): NICOLE ROMANO LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GROSSMAN DR
BRAINTREE MA
02184-4967
US

IV. Provider business mailing address

500 GROSSMAN DR
BRAINTREE MA
02184-4967
US

V. Phone/Fax

Practice location:
  • Phone: 774-268-8780
  • Fax:
Mailing address:
  • Phone: 774-268-8780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC8383
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: