Healthcare Provider Details

I. General information

NPI: 1487808127
Provider Name (Legal Business Name): ARTHUR DAVID ROMERO LPCC, LADAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2008
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 GOLF COURSE RD SE A
RIO RANCHO NM
87124-1762
US

IV. Provider business mailing address

1603 GOLF COURSE RD SE A
RIO RANCHO NM
87124-1762
US

V. Phone/Fax

Practice location:
  • Phone: 505-994-4100
  • Fax: 505-994-1229
Mailing address:
  • Phone: 505-994-4100
  • Fax: 505-994-1229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3468
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1044
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: