Provider Demographics
NPI:1972526580
Name:STAFFORD, ROBERT MCKINLEY III (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MCKINLEY
Last Name:STAFFORD
Suffix:III
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 1:800 FLEMING ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:828-693-9560
Practice Address - Street 1:72 BLUE RIDGE LN
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-7270
Practice Address - Country:US
Practice Address - Phone:828-682-2111
Practice Address - Fax:828-682-7630
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional