Provider Demographics
NPI:1881322543
Name:PARSONS, ROBERT EARL JR (MA, CRC, CVRT, LLPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EARL
Last Name:PARSONS
Suffix:JR
Gender:M
Credentials:MA, CRC, CVRT, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 S WESTNEDGE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-6032
Mailing Address - Country:US
Mailing Address - Phone:269-216-8640
Mailing Address - Fax:
Practice Address - Street 1:8080 MOORSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4421
Practice Address - Country:US
Practice Address - Phone:269-598-0587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451022412101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health