Healthcare Provider Details

I. General information

NPI: 1518992205
Provider Name (Legal Business Name): ROBERT L PHILLIPS M.A., LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 BELL RD PMB #77
BLAINE WA
98230-8062
US

IV. Provider business mailing address

2490 BELL RD PMB #77
BLAINE WA
98230-8062
US

V. Phone/Fax

Practice location:
  • Phone: 503-238-9755
  • Fax: 458-256-3185
Mailing address:
  • Phone: 503-238-9755
  • Fax: 458-256-3185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC6738
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC.LH.61613822
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: