Provider Demographics
NPI:1184075244
Name:HASSON, ROBERT GERARD III (LICSW)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:GERARD
Last Name:HASSON
Suffix:III
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ENGLEWOOD AVE
Mailing Address - Street 2:APARTMENT 22
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-7853
Mailing Address - Country:US
Mailing Address - Phone:207-838-5412
Mailing Address - Fax:
Practice Address - Street 1:1309 BEACON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5271
Practice Address - Country:US
Practice Address - Phone:781-281-8582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1196471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical