Healthcare Provider Details

I. General information

NPI: 1871463620
Provider Name (Legal Business Name): ELIZABETH ROMANO PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 11/07/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 W BIG BEAVER RD STE 520
TROY MI
48084-3442
US

IV. Provider business mailing address

1790 SCHOENITH LN
BLOOMFIELD MI
48302-2656
US

V. Phone/Fax

Practice location:
  • Phone: 248-646-6659
  • Fax: 248-842-8645
Mailing address:
  • Phone: 248-646-6659
  • Fax: 248-642-8645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6342001020
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: