Healthcare Provider Details

I. General information

NPI: 1346397544
Provider Name (Legal Business Name): ROBERT L MAPES LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 FERRIS AVE STE 107
WAXAHACHIE TX
75165-2590
US

IV. Provider business mailing address

103 CLEAR CREEK DR
RED OAK TX
75154-4067
US

V. Phone/Fax

Practice location:
  • Phone: 972-937-8255
  • Fax: 973-937-8504
Mailing address:
  • Phone: 972-617-6187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12009
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: