Provider Demographics
NPI:1538472410
Name:ROMERO, MICHELLE B (LMSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:B
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:MICHELLE
Other - Middle Name:B
Other - Last Name:ROMERO-MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 45822
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-5822
Mailing Address - Country:US
Mailing Address - Phone:505-269-0196
Mailing Address - Fax:
Practice Address - Street 1:3534 ANDERSON AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1612
Practice Address - Country:US
Practice Address - Phone:505-237-0061
Practice Address - Fax:505-237-0068
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-05925104100000X
NMC-109631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker