=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699317198
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBERT ANTHONY TOWNSEND LCSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2019
-----------------------------------------------------
Last Update Date | 05/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2300 REXWOODS DR STE 140
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27607-3361
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-360-3637
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5509 CREEDMOOR RD
-----------------------------------------------------
City | RALEIGH
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27612-6312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-573-6547
-----------------------------------------------------
Fax | 919-573-6555
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | C015098
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------