Provider Demographics
NPI:1194192161
Name:ROBERTO HUIE JR. ENTERPRISES, LLC
Entity Type:Organization
Organization Name:ROBERTO HUIE JR. ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:HUIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-265-5130
Mailing Address - Street 1:7946 GALLOPING CIR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1279
Mailing Address - Country:US
Mailing Address - Phone:410-265-5130
Mailing Address - Fax:410-265-6808
Practice Address - Street 1:5300 DORSEY HALL DR
Practice Address - Street 2:SUIE 203
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7791
Practice Address - Country:US
Practice Address - Phone:410-265-5130
Practice Address - Fax:410-265-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD081381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty