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Individual
DR. ROBERT MICHAEL IBRAHAM
Active
Individual
DR. ROBERT MICHAEL IBRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
JD, PHD, CASAC-M/G
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34794
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
028005-01
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
P128122
NY
103TC0700X
Clinical Psychologist
Primary
028005-01
NY
103TC0700X
Clinical Psychologist
Primary
P128122
NY
103TP2701X
Group Psychotherapy Psychologist
028005-01
NY
103TP2701X
Group Psychotherapy Psychologist
P128122
NY
Other
Enumeration date
09/20/2018
Last updated
05/13/2026
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