Provider Demographics
NPI:1891382040
Name:ROMINSKI, NICOLE (LICSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ROMINSKI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-5037
Mailing Address - Country:US
Mailing Address - Phone:952-334-6319
Mailing Address - Fax:
Practice Address - Street 1:3137 HENNEPIN AVE STE 202
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2602
Practice Address - Country:US
Practice Address - Phone:612-424-0053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN274851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical