Provider Demographics
NPI:1477561561
Name:FEWEL, ROBERT LYNN (LCSW, MSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LYNN
Last Name:FEWEL
Suffix:
Gender:M
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:16535 W BLUEMOUND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-5936
Mailing Address - Country:US
Mailing Address - Phone:262-789-1191
Mailing Address - Fax:262-821-6180
Practice Address - Street 1:16535 W BLUEMOUND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-5936
Practice Address - Country:US
Practice Address - Phone:262-789-1191
Practice Address - Fax:262-821-6180
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7401231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical