Provider Demographics
NPI:1821136540
Name:BERGEON, ROBIN C RABER (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:C RABER
Last Name:BERGEON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:C
Other - Last Name:RABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:N6981 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-4222
Mailing Address - Country:US
Mailing Address - Phone:715-853-8953
Mailing Address - Fax:715-201-0395
Practice Address - Street 1:420 E GREEN BAY ST STE 107
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-2500
Practice Address - Country:US
Practice Address - Phone:414-403-5535
Practice Address - Fax:414-403-5535
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical