Provider Demographics
NPI:1497116164
Name:COMPTON, ROBERT EDWIN (MA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWIN
Last Name:COMPTON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20789 CAMDEN SQ
Mailing Address - Street 2:# 203
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076
Mailing Address - Country:US
Mailing Address - Phone:313-408-7700
Mailing Address - Fax:
Practice Address - Street 1:640 TEMPLE ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2599
Practice Address - Country:US
Practice Address - Phone:313-344-9099
Practice Address - Fax:313-833-2155
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009083103T00000X, 103TC0700X, 103TC1900X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy