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General NPI Number Information
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NPI Number | 1285496158
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Entity Type | Organization
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Legal Business Name | ROBYN GLICKMAN LLC
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 5656 W MAPLE RD STE A
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3741
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Country | US
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Telephone | 248-255-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 21395 GLENMORE ST
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City | SOUTHFIELD
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State | MI
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Zip | 48076-6016
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Country | US
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Telephone | 248-255-4232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBYN GLICKMAN
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Credential | PHD, LMFT,LLP, CAADC
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Telephone | 248-943-9298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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