Provider Demographics
NPI:1700116290
Name:MUNCRIEF, ROBERT CLEVELAND III (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CLEVELAND
Last Name:MUNCRIEF
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 W. AIRPORT FREEWAY
Mailing Address - Street 2:SUITE 430
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-6259
Mailing Address - Country:US
Mailing Address - Phone:877-315-0488
Mailing Address - Fax:972-544-7102
Practice Address - Street 1:200 GREENE ROAD
Practice Address - Street 2:
Practice Address - City:WILMER
Practice Address - State:TX
Practice Address - Zip Code:75172
Practice Address - Country:US
Practice Address - Phone:866-562-2730
Practice Address - Fax:972-525-6320
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1658101YA0400X
TX5099101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)