MEDICARE: DR ROBERT M DANE COUNSELING SERVICES PLLC

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	101YP2500X	Professional Counselor	14671	TX

General Provider Information

NPI Number	:	1700217171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ROBERT M DANE COUNSELING SERVICES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 639
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78680-0639
Country	:	US
Telephone Number	:	512-413-0651
Fax Number	:	512-368-2801

Provider Business Practice Location Address
First Line	:	1315 SAM BASS CIR
Second Line	:	SUITE B3
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-2932
Country	:	US
Telephone Number	:	512-413-0651
Fax Number	:	512-368-2801

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	DR. ROBERT MICHAEL DANE
Credential	:	PH.D, LPC-S, LCDC
Telephone Number	:	512-413-0651

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	12/10/2013

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