Provider Demographics
NPI:1679695282
Name:HAWES, ROBERT D (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:HAWES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 TURNPIKE ST.
Mailing Address - Street 2:COLLABORATIONS IN CLINICAL CARE, SUITE 105
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2357
Mailing Address - Country:US
Mailing Address - Phone:781-821-3040
Mailing Address - Fax:781-821-1743
Practice Address - Street 1:275 TURNPIKE ST
Practice Address - Street 2:COLLABORATIONS IN CLINICAL CARE, SUITE 105
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2357
Practice Address - Country:US
Practice Address - Phone:781-821-3040
Practice Address - Fax:781-821-1743
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALM1128101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP10398OtherBCBS GROUP #
MA1102303Medicaid
MAA019232OtherHPHC
MALM0551OtherBLUE CROSS BLUE SHIELD MA