Provider Demographics
NPI:1386318368
Name:DONOVAN, ROBERT CHAPMAN (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHAPMAN
Last Name:DONOVAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 PARADISE RD UNIT 1230
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2954
Mailing Address - Country:US
Mailing Address - Phone:781-413-1309
Mailing Address - Fax:
Practice Address - Street 1:84 ANTIETAM STREET
Practice Address - Street 2:
Practice Address - City:DEVENS
Practice Address - State:MA
Practice Address - Zip Code:01434
Practice Address - Country:US
Practice Address - Phone:888-224-7312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0002269521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical