Provider Demographics
NPI:1205631132
Name:DONALDSON, ROBERT HUGH IV (LAC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HUGH
Last Name:DONALDSON
Suffix:IV
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802B ALBRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2650
Mailing Address - Country:US
Mailing Address - Phone:609-661-2421
Mailing Address - Fax:
Practice Address - Street 1:2135 NJ-33
Practice Address - Street 2:
Practice Address - City:HAMILTON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-588-9989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00848700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty