MEDICARE: JOSELYN ROMERO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	8983587-3501	UT

General Provider Information

NPI Number	:	1336518737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSELYN ROMERO LCSW

Provider Business Mailing Address
First Line	:	4821 S KINGS ROW DR APT 31
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-5963
Country	:	US
Telephone Number	:	385-386-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 S 1000 E STE 200
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-1496
Country	:	US
Telephone Number	:	801-487-2323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2015
Last Update Date	:	08/11/2023

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