Provider Demographics
NPI:1588963557
Name:WOMACK, ROBERT PAUL JR (LPCA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PAUL
Last Name:WOMACK
Suffix:JR
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N DUKE ST
Mailing Address - Street 2:#54-208
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-2071
Mailing Address - Country:US
Mailing Address - Phone:919-682-6549
Mailing Address - Fax:
Practice Address - Street 1:500 N DUKE ST
Practice Address - Street 2:#54-208
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2071
Practice Address - Country:US
Practice Address - Phone:919-682-6549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8253101Y00000X, 101YM0800X, 101YP1600X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral