Basic Information
| Provider Information | |||||||||
| NPI: | 1699317198 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOWNSEND | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LCSWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5509 CREEDMOOR RD | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276126312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9195736547 | ||||||||
| FaxNumber: | 9195736555 | ||||||||
| Practice Location | |||||||||
| Address1: | 3 CENTERVIEW DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | GREENSBORO | ||||||||
| State: | NC | ||||||||
| PostalCode: | 274073728 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368349664 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2019 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C015098 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.