Provider Demographics
NPI:1073795589
Name:WILLIFORD, ROBIN MICHELLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:MICHELLE
Last Name:WILLIFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-4022
Mailing Address - Country:US
Mailing Address - Phone:479-494-5760
Mailing Address - Fax:
Practice Address - Street 1:815 FORT ST
Practice Address - Street 2:SUITE A
Practice Address - City:BARLING
Practice Address - State:AR
Practice Address - Zip Code:72923-2164
Practice Address - Country:US
Practice Address - Phone:479-494-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0811094101Y00000X
171M00000X
ARP1104026101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator