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NPI Code Detail

MEDICARE: MR. RODOLFO M ESCOBAR JR. LPC

MEDICARE:  MR. RODOLFO M ESCOBAR JR. LPC
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
1101YP2500XProfessional Counselor0701005045VA

General Provider Information

NPI Number : 1295098879
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RODOLFO M ESCOBAR JR. LPC
Provider Business Mailing Address
First Line : 7116 KIRBY CRES
Second Line :
City : NORFOLK
State : VA
Zip : 23505-4217
Country : US
Telephone Number : 757-587-3444
Fax Number :
Provider Business Practice Location Address
First Line : 225 W OLNEY RD
Second Line :
City : NORFOLK
State : VA
Zip : 23510-1534
Country : US
Telephone Number : 757-823-1710
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2012
Last Update Date : 06/19/2012

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Directions to “ MR. RODOLFO M ESCOBAR JR. LPC” Practice Location

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