Provider Demographics
NPI:1659593580
Name:EASTON, ROBERT R (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:EASTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MUNDY DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86351-9539
Mailing Address - Country:US
Mailing Address - Phone:928-853-8269
Mailing Address - Fax:928-496-2075
Practice Address - Street 1:6560 RT. 179
Practice Address - Street 2:SUITE 204
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86351
Practice Address - Country:US
Practice Address - Phone:928-853-8269
Practice Address - Fax:928-496-2075
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-1329101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional