Provider Demographics
NPI:1265651202
Name:DICHIARO, ROBERT G (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:G
Last Name:DICHIARO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 FARRINGTON DR APT A
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2910
Mailing Address - Country:US
Mailing Address - Phone:505-815-9648
Mailing Address - Fax:505-815-9648
Practice Address - Street 1:3820 MERTON DR
Practice Address - Street 2:SUITE 217
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6609
Practice Address - Country:US
Practice Address - Phone:919-341-5799
Practice Address - Fax:919-341-5677
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5559101YM0800X
NM0082551101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103537Medicaid