MEDICARE: MR. ROBERT R SANFILIPPO LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	NVMFT0262	NV

General Provider Information

NPI Number	:	1184732729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT R SANFILIPPO LMFT

Provider Business Mailing Address
First Line	:	PO BOX 2365
Second Line	:
City	:	STATELINE
State	:	NV
Zip	:	89449-2365
Country	:	US
Telephone Number	:	775-588-9407
Fax Number	:	775-588-5458

Provider Business Practice Location Address
First Line	:	310 DORLA COURT
Second Line	:	SUITE 201
City	:	ZEPHYR COVE
State	:	NV
Zip	:	89448
Country	:	US
Telephone Number	:	775-588-9407
Fax Number	:	775-588-5458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	07/08/2007

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Directions to “ MR. ROBERT R SANFILIPPO LMFT” Practice Location

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