Provider Demographics
NPI:1306083043
Name:BEARE, ROBERT K JR (MA, LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:K
Last Name:BEARE
Suffix:JR
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 DICKSON DR APT 149
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4787
Mailing Address - Country:US
Mailing Address - Phone:512-803-9038
Mailing Address - Fax:
Practice Address - Street 1:2121 DICKSON DR APT 149
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-4787
Practice Address - Country:US
Practice Address - Phone:512-803-9038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14075101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health