Provider Demographics
NPI:1609988849
Name:ATHERTON, ROBERT MARTIN (MS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MARTIN
Last Name:ATHERTON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7602 PACIFIC ST #305
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-393-8277
Mailing Address - Fax:402-393-3609
Practice Address - Street 1:7602 PACIFIC ST #305
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114
Practice Address - Country:US
Practice Address - Phone:402-393-8277
Practice Address - Fax:402-393-3609
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2295101YM0800X
NELMHP554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health