Provider Demographics
NPI:1609078948
Name:PASFIELD, ROBERT EDWARD (MED, MS, MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWARD
Last Name:PASFIELD
Suffix:
Gender:M
Credentials:MED, MS, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5812 MOOSE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1524
Mailing Address - Country:US
Mailing Address - Phone:704-591-0383
Mailing Address - Fax:
Practice Address - Street 1:5812 MOOSE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-1524
Practice Address - Country:US
Practice Address - Phone:704-591-0383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0022431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC002243OtherLICENSED CLINICAL SW
NC6003417Medicaid