Provider Demographics
NPI:1225429723
Name:MERWIN, ROBERT B JR (LPC, CADCIII, CGACII)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:B
Last Name:MERWIN
Suffix:JR
Gender:M
Credentials:LPC, CADCIII, CGACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CHARLOTTE ST. NE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-4459
Mailing Address - Country:US
Mailing Address - Phone:541-429-0542
Mailing Address - Fax:
Practice Address - Street 1:310 CHARLOTTE ST. NE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-9732
Practice Address - Country:US
Practice Address - Phone:541-429-0542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10-09-37101YA0400X
ORC3975101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)