Provider Demographics
NPI:1164730461
Name:RASNAKE, ROBERT TEMPLIN (LPCC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:TEMPLIN
Last Name:RASNAKE
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 1:75 CAVALIER BLVD
Mailing Address - Street 2:STE. 110
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3950
Mailing Address - Country:US
Mailing Address - Phone:859-594-4510
Mailing Address - Fax:859-594-4519
Practice Address - Street 1:75 CAVALIER BLVD
Practice Address - Street 2:STE. 110
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3950
Practice Address - Country:US
Practice Address - Phone:859-594-4510
Practice Address - Fax:859-594-4519
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0521101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical