Provider Demographics
NPI:1518397967
Name:AUVILLE, ROBERT (MED, CSAC, LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:AUVILLE
Suffix:
Gender:M
Credentials:MED, CSAC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:POUNDING MILL
Mailing Address - State:VA
Mailing Address - Zip Code:24637-0683
Mailing Address - Country:US
Mailing Address - Phone:276-244-1380
Mailing Address - Fax:
Practice Address - Street 1:19873 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:GRUNDY
Practice Address - State:VA
Practice Address - Zip Code:24614
Practice Address - Country:US
Practice Address - Phone:276-244-1380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005654101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health