Basic Information
| Provider Information | |||||||||
| NPI: | 1366815235 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | METZLER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | IV | ||||||||
| Credential: | MSW, LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 331 WETHERSFIELD AVE STE 2 | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061141438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602364511 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 331 WETHERSFIELD AVE STE 2 | ||||||||
| Address2: | |||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061141438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602364511 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2015 | ||||||||
| LastUpdateDate: | 07/31/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | MA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 3710 | CT | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.