Provider Demographics
NPI:1558377085
Name:HAAS, ROBERT C (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:HAAS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-1824
Mailing Address - Country:US
Mailing Address - Phone:503-655-8558
Mailing Address - Fax:503-655-8197
Practice Address - Street 1:524 MAIN ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1824
Practice Address - Country:US
Practice Address - Phone:503-655-8558
Practice Address - Fax:503-655-8197
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL29091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORQ26102Medicare UPIN
OR121313Medicare ID - Type Unspecified