Provider Demographics
NPI:1588858765
Name:ROMBERG, DOUGLAS LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:LEE
Last Name:ROMBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 R ST NW
Mailing Address - Street 2:SUITE C-5
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1625
Mailing Address - Country:US
Mailing Address - Phone:202-296-0033
Mailing Address - Fax:202-387-7108
Practice Address - Street 1:1800 R ST NW
Practice Address - Street 2:SUITE C-5
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1625
Practice Address - Country:US
Practice Address - Phone:202-296-0033
Practice Address - Fax:202-387-7108
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1389103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist