Provider Demographics
NPI:1033466065
Name:SLONE, ROBERT TAYLOR (LPCC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TAYLOR
Last Name:SLONE
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 12TH ST
Mailing Address - Street 2:
Mailing Address - City:CLAY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:40312-8979
Mailing Address - Country:US
Mailing Address - Phone:606-663-9011
Mailing Address - Fax:606-663-9012
Practice Address - Street 1:108 12TH ST
Practice Address - Street 2:
Practice Address - City:CLAY CITY
Practice Address - State:KY
Practice Address - Zip Code:40312-8979
Practice Address - Country:US
Practice Address - Phone:606-663-9011
Practice Address - Fax:606-663-9012
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0558101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional