MEDICARE: ROBERT WEBSTER M.S, NCC, LPC, CMATS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101Y00000X	Counselor
3	101YP2500X	Professional Counselor	7589	NC

General Provider Information

NPI Number	:	1568764710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT WEBSTER M.S, NCC, LPC, CMATS

Provider Business Mailing Address
First Line	:	PO BOX 15507
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28561-5507
Country	:	US
Telephone Number	:	252-723-0595
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 US HIGHWAY 70 E STE C
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28560-6818
Country	:	US
Telephone Number	:	252-723-0595
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2010
Last Update Date	:	11/11/2011

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