Provider Demographics
NPI:1093351108
Name:ROBERT, FATEMAH R (LPC)
Entity Type:Individual
Prefix:MRS
First Name:FATEMAH
Middle Name:R
Last Name:ROBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16433 ANNA BELLE DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-5880
Mailing Address - Country:US
Mailing Address - Phone:225-954-4379
Mailing Address - Fax:
Practice Address - Street 1:16433 ANNA BELLE DR
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-5880
Practice Address - Country:US
Practice Address - Phone:225-954-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-24
Last Update Date:2019-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional