1033472675 NPI number — MR. CHARLES RICHARD ROBSON L.M.S.W.

Table of content: MR. CHARLES RICHARD ROBSON L.M.S.W. (NPI 1033472675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033472675 NPI number — MR. CHARLES RICHARD ROBSON L.M.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBSON
Provider First Name:
CHARLES
Provider Middle Name:
RICHARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
L.M.S.W.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033472675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9943 HICKMAN RD
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
URBANDALE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50322-5304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-248-1447
Provider Business Mailing Address Fax Number:
515-248-1440

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
412 E CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALLTOWN
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50158-2947
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-753-4021
Provider Business Practice Location Address Fax Number:
641-753-4025
Provider Enumeration Date:
06/19/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  007985 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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