Healthcare Provider Details

I. General information

NPI: 1740902493
Provider Name (Legal Business Name): ROBERT DEWEY SCHALES LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 HACKBERRY STREET
TILDEN TX
78072
US

IV. Provider business mailing address

PO BOX 2330
GEORGE WEST TX
78022-2330
US

V. Phone/Fax

Practice location:
  • Phone: 361-274-3690
  • Fax:
Mailing address:
  • Phone: 361-449-5173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12023
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number99363
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number70419
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: