Robert Michael Gollenberg , MED, CRC
Counselor • Fort Wayne, IN
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Robert Gollenberg has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Robert Gollenberg, MED, CRC was a registered Counselor practicing in Fort Wayne, IN. Throughout an active medical career spanning 12 years, Robert Gollenberg provided care at the practice location at 2121 LAKE AVE until profile deactivation on 2018-10-22.
Practice Location & Contact Primary Location
2121 Lake Ave
Room 423, Vocational Rehabilitation
Fort Wayne, IN 468055100
Specialty Benchmarks & Practice Insights
Comparative analytics for Counselor in Fort Wayne, IN
Practicing in Fort Wayne, IN (1327 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Registered Nurse - Oncology
Pharmacist
Doctor of Pharmacy (Pharm.D.)
Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Doctor of Pharmacy (Pharm.D.)
Registered Nurse
Surgery
Doctor of Medicine (M.D.)
Social Worker - Clinical
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on October 22, 2018
NPI status registered as active in NPPES database
Registered at 2121 LAKE AVE, ROOM 423, VOCATIONAL REHABILITATION, FORT WAYNE, IN 468055100 (Tel: 2604265431)
Registered at 2121 LAKE AVE, ROOM 423, VOCATIONAL REHABILITATION, FORT WAYNE, IN 468055100 (Tel: 2604265431)
Recorded as ROBERT GOLLENBERG, M.ED.,CRC
Counselor (License #C35039 in IL)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
2121 Lake Ave, Room 423, Vocational Rehabilitation
Fort Wayne, IN 468055100
Phone: 2604265431
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