Provider Demographics
NPI:1902644156
Name:ROMERO, MADELEINE ISABEL (LMSW)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:ISABEL
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7016 68TH PL
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-6619
Mailing Address - Country:US
Mailing Address - Phone:929-420-7759
Mailing Address - Fax:
Practice Address - Street 1:9114 37TH AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7920
Practice Address - Country:US
Practice Address - Phone:347-612-4133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123340104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker