Provider Demographics
NPI:1669524708
Name:COLEN, ROBERT STEVEN (LMHC MA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEVEN
Last Name:COLEN
Suffix:
Gender:M
Credentials:LMHC MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24761 US 19 NORTH
Mailing Address - Street 2:STE 680
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763
Mailing Address - Country:US
Mailing Address - Phone:727-712-9094
Mailing Address - Fax:
Practice Address - Street 1:24761 US 19 NORTH
Practice Address - Street 2:STE 680
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763
Practice Address - Country:US
Practice Address - Phone:727-712-9094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health