Provider Demographics
NPI:1245333194
Name:KERNS, ROBERT D (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:KERNS
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:PSYCHOLOGY SERVICE
Mailing Address - Street 2:VA CONNECTICUT HEALTHCARE SYSTEM
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2770
Mailing Address - Country:US
Mailing Address - Phone:203-937-3841
Mailing Address - Fax:203-937-4951
Practice Address - Street 1:PSYCHOLOGY SERVICE
Practice Address - Street 2:VA CONNECTICUT HEALTHCARE SYSTEM
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2770
Practice Address - Country:US
Practice Address - Phone:203-937-3841
Practice Address - Fax:203-937-4951
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00927103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical