Provider Demographics
NPI:1649244013
Name:ROBDAU, VERONICA MARIE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:MARIE
Last Name:ROBDAU
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ROYAL PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1961
Mailing Address - Country:US
Mailing Address - Phone:508-996-6684
Mailing Address - Fax:508-990-4777
Practice Address - Street 1:134 SUITE C LADY'S ISLAND DRIVE
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907
Practice Address - Country:US
Practice Address - Phone:508-688-2912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10193481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1851667Medicaid
173727000OtherMAGELLAN EAP
MAP05597OtherBCBS