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NPI Code Detail

MEDICARE: MR. ROBIN RAY WHITEHEAD LPC

MEDICARE: MR. ROBIN RAY WHITEHEAD 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 Counselor80290TX

General Provider Information

NPI Number : 1770318859
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBIN RAY WHITEHEAD LPC
Provider Business Mailing Address
First Line : 2718 MCCART AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-2231
Country : US
Telephone Number : 214-603-9699
Fax Number :
Provider Business Practice Location Address
First Line : 3910 W INTERSTATE 20 STE 100
Second Line :
City : ARLINGTON
State : TX
Zip : 76017-1430
Country : US
Telephone Number : 817-812-2880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2024
Last Update Date : 09/06/2024

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Directions to “ MR. ROBIN RAY WHITEHEAD LPC” Practice Location

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