Provider Demographics
NPI:1871809921
Name:ROMAN, CARISIA (LCSW)
Entity type:Individual
Prefix:
First Name:CARISIA
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CARIS
Other - Middle Name:
Other - Last Name:ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 N. TRADEWINDS AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-554-4141
Mailing Address - Fax:
Practice Address - Street 1:4737 N OCEAN DR
Practice Address - Street 2:SUITE 177
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-2920
Practice Address - Country:US
Practice Address - Phone:954-492-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2023-03-14
Deactivation Date:2012-04-19
Deactivation Code:
Reactivation Date:2023-03-14
Provider Licenses
StateLicense IDTaxonomies
FLSW97301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical