Provider Demographics
NPI:1104224484
Name:ROMANOWITZ, MADISON (MFT)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:ROMANOWITZ
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1662 US HIGHWAY 395 N STE 109
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4328
Mailing Address - Country:US
Mailing Address - Phone:775-720-1566
Mailing Address - Fax:
Practice Address - Street 1:1662 US HIGHWAY 395 N STE 109
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4328
Practice Address - Country:US
Practice Address - Phone:775-720-1566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2627106H00000X
NVM10710106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist