Individual provider Active NPI

Robert Brown Fortney, NCC, LPC

  • Professional Counselor
  • Lubbock, TX
National Provider Identifier
1376617720
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
18987 Issued in TX
Practice address
3302 34TH St
Lubbock, TX 79410-3232
Phone
(806) 790-9090
Fax
(806) 792-6156
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 18987 TX Primary

Addresses

Primary practice location

3302 34TH St
Lubbock, TX 79410-3232

Mailing address

5702 62ND St
Lubbock, TX 79424-1206
Phone (806) 790-9090

Other identifiers 1

IdentifierTypeStateIssuer
184162901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
18987TXMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1376617720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 62ND ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794241206",
            "telephone_number": "806-790-9090",
            "fax_number": "806-792-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 34TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794103232",
            "telephone_number": "806-790-9090",
            "fax_number": "806-792-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTNEY",
        "first_name": "ROBERT",
        "middle_name": "BROWN",
        "name_prefix": "Mr.",
        "credential": "NCC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "18987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184162901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.