Provider Demographics
NPI:1598897282
Name:ALLEN, ROBERT CHAD (MA)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHAD
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 LAURENDALE CT
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315
Mailing Address - Country:US
Mailing Address - Phone:704-438-1309
Mailing Address - Fax:910-673-6565
Practice Address - Street 1:241 GRANT ST
Practice Address - Street 2:
Practice Address - City:SEVEN LAKES
Practice Address - State:NC
Practice Address - Zip Code:27376
Practice Address - Country:US
Practice Address - Phone:910-673-3535
Practice Address - Fax:910-673-6565
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC214486101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor