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NPI Code Detail

MEDICARE: ROBERTSON SERVICES LLC

MEDICARE: ROBERTSON SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801086213MI

General Provider Information

NPI Number : 1245694793
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROBERTSON SERVICES LLC
Provider Business Mailing Address
First Line : 441 SWARTZ CT
Second Line :
City : IONIA
State : MI
Zip : 48846-2157
Country : US
Telephone Number : 616-523-6537
Fax Number : 616-523-6536
Provider Business Practice Location Address
First Line : 441 SWARTZ CT
Second Line :
City : IONIA
State : MI
Zip : 48846-2157
Country : US
Telephone Number : 616-523-6537
Fax Number : 616-523-6536
Authorized Official
Title or Position : OWNER
Name : DEREK ROBERTSON
Credential : LMSW
Telephone Number : 616-523-6537
Provider Enumeration Date : 04/11/2016
Last Update Date : 03/26/2021

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