Provider Demographics
NPI:1174256333
Name:WHELAN, ROBERT WILLIAM (MA/EDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WILLIAM
Last Name:WHELAN
Suffix:
Gender:M
Credentials:MA/EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BEDFORD HILLS DR
Mailing Address - Street 2:
Mailing Address - City:EARLYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22936-9503
Mailing Address - Country:US
Mailing Address - Phone:434-825-2387
Mailing Address - Fax:
Practice Address - Street 1:1001 E MARKET ST STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5381
Practice Address - Country:US
Practice Address - Phone:434-825-2387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health