Provider Demographics
NPI:1730263179
Name:NEIHEISEL, ROBIN II (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:NEIHEISEL
Suffix:II
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 THOMPSON BRIDGE RD # 3
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1663
Mailing Address - Country:US
Mailing Address - Phone:770-531-5664
Mailing Address - Fax:770-531-6341
Practice Address - Street 1:1856 THOMPSON BRIDGE RD # 3
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-1663
Practice Address - Country:US
Practice Address - Phone:770-531-5664
Practice Address - Fax:770-531-6341
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0013061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical