Healthcare Provider Details

I. General information

NPI: 1629226998
Provider Name (Legal Business Name): ROBERT EMERSON WILLBEE III PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 S GEAR AVE SUITE 251
WEST BURLINGTON IA
52655
US

IV. Provider business mailing address

1225 S GEAR AVE SUITE 251
WEST BURLINGTON IA
52655-1691
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-3700
  • Fax:
Mailing address:
  • Phone: 319-768-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001106
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1043
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number096771
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number02891
License Number StateIA
# 5
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number096771
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: