Provider Demographics
NPI:1912161282
Name:MCBRIDE, ROBERT WAYNE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:WAYNE
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 E ARAPAHOE RD
Mailing Address - Street 2:#115
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2090
Mailing Address - Country:US
Mailing Address - Phone:303-773-2616
Mailing Address - Fax:303-797-9198
Practice Address - Street 1:3939 E ARAPAHOE RD
Practice Address - Street 2:#115
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-2090
Practice Address - Country:US
Practice Address - Phone:303-773-2616
Practice Address - Fax:303-797-9198
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9925931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical