Provider Demographics
NPI:1215156732
Name:ROMAYKO, ELISABETH ANNE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:ANNE
Last Name:ROMAYKO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16220 S FREDERICK AVE STE 512
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-4022
Mailing Address - Country:US
Mailing Address - Phone:301-977-7782
Mailing Address - Fax:301-977-8287
Practice Address - Street 1:16220 S FREDERICK AVE STE 512
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-4022
Practice Address - Country:US
Practice Address - Phone:301-977-7782
Practice Address - Fax:301-977-8287
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01978101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health