Provider Demographics
NPI:1861691263
Name:EBERSOLE, ROBERT H JR (LMFT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:EBERSOLE
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913
Mailing Address - Country:US
Mailing Address - Phone:978-880-3591
Mailing Address - Fax:978-312-1895
Practice Address - Street 1:100 MAIN ST.
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-5201
Practice Address - Country:US
Practice Address - Phone:978-880-3591
Practice Address - Fax:978-312-1895
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1426106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist