Provider Demographics
NPI:1740409713
Name:FAUCETTE, ROBERT CHESTER (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHESTER
Last Name:FAUCETTE
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 1:11111 CARMEL COMMONS BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-5319
Mailing Address - Country:US
Mailing Address - Phone:704-540-7525
Mailing Address - Fax:
Practice Address - Street 1:11111 CARMEL COMMONS BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-5319
Practice Address - Country:US
Practice Address - Phone:704-540-7525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2114103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical