Provider Demographics
NPI:1851887251
Name:DICARLO, ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:DICARLO
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 1:8350 E RAINTREE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2691
Mailing Address - Country:US
Mailing Address - Phone:480-840-0400
Mailing Address - Fax:480-840-0499
Practice Address - Street 1:8350 E RAINTREE DR STE 120
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2691
Practice Address - Country:US
Practice Address - Phone:480-840-0400
Practice Address - Fax:480-840-0499
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-004980103TB0200X, 103TC1900X, 103TF0000X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily