Individual provider Active NPI

Edward T Romero III, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1841374147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCS14174 Issued in CA
Practice address
1224 Vine St
Los Angeles, CA 90038-1612
Phone
(323) 769-6100
Fax
(323) 769-4672
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCS14174 CA Primary

Addresses

Primary practice location

1224 Vine St
Los Angeles, CA 90038-1612

Mailing address

1224 Vine St
Los Angeles, CA 90038-1612
Phone (323) 769-6100

Other names 1

  • Ed Romero Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140919000005 CA Practitioner - Clinical Social Worker 8527141555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS14174CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health CurrentSince Feb 21, 2009 Accepting new patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Feb 21, 2009 Accepting new patients

Locations

1224 Vine St
Los Angeles, CA 90038
Phone (323) 769-6100

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841374147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 VINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381612",
            "telephone_number": "323-769-6100",
            "fax_number": "323-769-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 VINE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900381612",
            "telephone_number": "323-769-6100",
            "fax_number": "323-769-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "EDWARD",
        "middle_name": "T",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCS14174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ED",
            "last_name": "ROMERO",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.