Healthcare Provider Details

I. General information

NPI: 1134898281
Provider Name (Legal Business Name): ROMEO FOTSO LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2021
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7474 GREENWAY CENTER DR STE 202
GREENBELT MD
20770-3504
US

IV. Provider business mailing address

7474 GREENWAY CENTER DR STE 200
GREENBELT MD
20770-3524
US

V. Phone/Fax

Practice location:
  • Phone: 240-304-3327
  • Fax:
Mailing address:
  • Phone: 240-304-3327
  • Fax: 410-609-7091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27698
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: