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MS. LORI ANNETTE ROBERTSON LCSW, LCAC

Addiction Substance Use Disorder

Kokomo, Indiana

Provider NPI: 1124056460

Provider Information:
MS. LORI ANNETTE ROBERTSON LCSW, LCAC
Gender: F
Not Sole Proprietor

Practice Location:
1810 DOGWOOD DR  KOKOMO, IN 46902 US
Tel: 260-274-0230  Fax: 260-274-1500

Business Mailing Address:
1810 DOGWOOD DR  KOKOMO, IN 46902 US
Tel: 260-274-0230  Fax: 260-274-1500

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
IN87000744A
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
IN34005967A

Other Provider Identifiers:

IssuerNumberStateType
ICADC14574IN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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