Provider Demographics
NPI:1992337182
Name:ANTHONY, ROBERT WILLIAM (LPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9331 PINEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-4758
Mailing Address - Country:US
Mailing Address - Phone:214-402-0910
Mailing Address - Fax:214-594-8284
Practice Address - Street 1:9330 LYNDON B JOHNSON FWY STE 949
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3436
Practice Address - Country:US
Practice Address - Phone:214-402-0910
Practice Address - Fax:214-594-8284
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75485101YP2500X, 101Y00000X, 101YM0800X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health