Provider Demographics
NPI:1083942858
Name:HEJNA, ROBERT JOHN (LSW, ACSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:HEJNA
Suffix:
Gender:M
Credentials:LSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10916 BRAUN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-8202
Mailing Address - Country:US
Mailing Address - Phone:517-456-8163
Mailing Address - Fax:
Practice Address - Street 1:2750 S STATE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6179
Practice Address - Country:US
Practice Address - Phone:734-662-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-06
Last Update Date:2009-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010154351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical