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General NPI Number Information
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NPI Number | 1003435546
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Entity Type | Individual
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Provider Name | MICAELA ROMERO LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 04/14/2020
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Provider Practice Location Address
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Address Line | 2115 STUART AVE
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City | ALAMOSA
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State | CO
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Zip | 81101-2269
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Country | US
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Telephone | 719-589-8008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 454
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City | MANASSA
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State | CO
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Zip | 81141-0454
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Country | US
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Telephone | 719-250-1183
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 59318
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09926292
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License Number State | CO
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