Provider Demographics
NPI:1891154324
Name:SHIVE, ROBERT M JR (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:SHIVE
Suffix:JR
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1854 W AUBURN RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3868
Mailing Address - Country:US
Mailing Address - Phone:248-844-2647
Mailing Address - Fax:248-429-1516
Practice Address - Street 1:1854 W AUBURN RD STE 210
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3868
Practice Address - Country:US
Practice Address - Phone:248-844-2647
Practice Address - Fax:248-429-1516
Is Sole Proprietor?:No
Enumeration Date:2016-02-11
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional