Provider Demographics
NPI:1073680294
Name:LAYZOD, ROBERT JAMES (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:LAYZOD
Suffix:
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 1:6312 PICCADILLY SQUARE DR STE 3
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5217
Mailing Address - Country:US
Mailing Address - Phone:251-343-5300
Mailing Address - Fax:
Practice Address - Street 1:6312 PICCADILLY SQUARE DR STE 3
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5217
Practice Address - Country:US
Practice Address - Phone:251-343-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4021101YM0800X
ALMASTERS101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051535977OtherBC/BS OF ALABAMA
AL051535977OtherBCBS OF AL PROVIDER #
AL1073680294Medicaid