Provider Demographics
NPI:1366655300
Name:WILCOX, ROBERT F (LPCC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:F
Last Name:WILCOX
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11104 PINON AZUL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114
Mailing Address - Country:US
Mailing Address - Phone:505-803-0501
Mailing Address - Fax:505-323-9430
Practice Address - Street 1:3901 LOUISIANA NE STE 2
Practice Address - Street 2:ACCELERATED FAMILY COUNSELING
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-888-1686
Practice Address - Fax:505-888-1683
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2052101YM0800X
NM0161861101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMM1855Medicaid
NMNM600109Medicaid
NMNM1919Medicaid