Provider Demographics
NPI:1487729844
Name:ROBY, WILLIAM DOYLE II (LCSW)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DOYLE
Last Name:ROBY
Suffix:II
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:DOYLE
Other - Last Name:ROBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95473-0111
Mailing Address - Country:US
Mailing Address - Phone:707-571-3229
Mailing Address - Fax:
Practice Address - Street 1:401 BICENTENNIAL WAY
Practice Address - Street 2:FMS
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2149
Practice Address - Country:US
Practice Address - Phone:707-571-3229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS108651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical