1518992205 NPI number — ROBERT L PHILLIPS M.A., LPC

Table of content: ROBERT L PHILLIPS M.A., LPC (NPI 1518992205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518992205 NPI number — ROBERT L PHILLIPS M.A., LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PHILLIPS
Provider First Name:
ROBERT
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., LPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518992205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2490 BELL RD
Provider Second Line Business Mailing Address:
PMB #77
Provider Business Mailing Address City Name:
BLAINE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98230-8062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-238-9755
Provider Business Mailing Address Fax Number:
458-256-3185

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2490 BELL RD
Provider Second Line Business Practice Location Address:
PMB #77
Provider Business Practice Location Address City Name:
BLAINE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98230-8062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-238-9755
Provider Business Practice Location Address Fax Number:
458-256-3185
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  C6738 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: MHC.LH.61613822 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com