Provider Demographics
NPI:1144336330
Name:CARBO, ROBERT JOHN (LCSW C)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JOHN
Last Name:CARBO
Suffix:
Gender:M
Credentials:LCSW C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6213 ASHTON PARK COURT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3947
Mailing Address - Country:US
Mailing Address - Phone:410-964-1770
Mailing Address - Fax:410-964-1898
Practice Address - Street 1:6213 ASHTON PARK COURT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3947
Practice Address - Country:US
Practice Address - Phone:410-964-1770
Practice Address - Fax:410-964-1898
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD47801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
552RMedicare ID - Type Unspecified