Provider Demographics
NPI:1255970851
Name:ROBERT L GEIST, PHD, LLC
Entity type:Organization
Organization Name:ROBERT L GEIST, PHD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSCYHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:GEIST
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:256-694-0649
Mailing Address - Street 1:24 WAX LN SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35824-4086
Mailing Address - Country:US
Mailing Address - Phone:256-694-0649
Mailing Address - Fax:
Practice Address - Street 1:9238 MADISON BLVD STE 119
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9112
Practice Address - Country:US
Practice Address - Phone:256-510-5400
Practice Address - Fax:256-510-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-30
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty