Healthcare Provider Details

I. General information

NPI: 1063039600
Provider Name (Legal Business Name): JENNIFER ALYSE ROMANO MORRIS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 LEE ST
CHARLOTTESVILLE VA
22908-0816
US

IV. Provider business mailing address

510 BUTLER AVE
MARTINSBURG WV
25405-9990
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-2718
  • Fax: 434-243-6546
Mailing address:
  • Phone: 800-817-3807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810007709
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: