Healthcare Provider Details

I. General information

NPI: 1982185849
Provider Name (Legal Business Name): MARIE ARRUDA ROMERO MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MILL RD
FAIRHAVEN MA
02719-5252
US

IV. Provider business mailing address

231 LYNCH AVE
SOMERSET MA
02726-4050
US

V. Phone/Fax

Practice location:
  • Phone: 508-973-3200
  • Fax:
Mailing address:
  • Phone: 508-558-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW02312
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number117063
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: