Provider Demographics
NPI:1528517372
Name:ROMAN, KARL D (LMSW, LSW,LCSW)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:D
Last Name:ROMAN
Suffix:
Gender:M
Credentials:LMSW, LSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 493
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-0493
Mailing Address - Country:US
Mailing Address - Phone:973-858-8163
Mailing Address - Fax:
Practice Address - Street 1:400 RAMAPO AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-1825
Practice Address - Country:US
Practice Address - Phone:973-858-8163
Practice Address - Fax:862-666-1074
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078341041C0700X
NJ44SC059787001041C0700X, 104100000X
101YA0400X
NY098850104100000X
FLSW233231041C0700X
NY0906681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker