Provider Demographics
NPI:1649742792
Name:KAISER, ROBERT JOSEPH JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:KAISER
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20643 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1523
Mailing Address - Country:US
Mailing Address - Phone:313-671-9689
Mailing Address - Fax:
Practice Address - Street 1:22708 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1823
Practice Address - Country:US
Practice Address - Phone:586-445-2210
Practice Address - Fax:586-445-0070
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017085101Y00000X
MI6401019644101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor