Provider Demographics
NPI:1720331770
Name:HENRIES, ROBERT BOWEN (LLMSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BOWEN
Last Name:HENRIES
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:G
Other - Last Name:SAYDEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:2500 7TH AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-1176
Mailing Address - Country:US
Mailing Address - Phone:906-233-1322
Mailing Address - Fax:906-233-1220
Practice Address - Street 1:2500 7TH AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-1176
Practice Address - Country:US
Practice Address - Phone:906-233-1322
Practice Address - Fax:906-233-1220
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010948001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical