Doctor Name: | CHARISSA ROSE ROBERT |
NPI Number: | 1083981898 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW-CC |
License Number: | MC12608 |
Business Practice Address: | 15 Saunders Way Suite #720 Westbrook, ME - 040924833 |
Business Phone Number: | 2078789663 |
Business Fax Number: | |
Mailing Address: | 4 Mcgill Fern Rd, STANDISH |
State: | ME |
Postal Code: | 040846529 |
Phone Number: | 2073182324 |
Fax Number: | |
NPI Enumeration Date: | 11/22/2011 |
NPI Last Update Date: | 11/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | MC12608 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |