Provider Demographics
NPI:1407101967
Name:LLOYD, ROBERT BENNION (CSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BENNION
Last Name:LLOYD
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 N 400 W
Mailing Address - Street 2:
Mailing Address - City:EPHRAIM
Mailing Address - State:UT
Mailing Address - Zip Code:84627-5549
Mailing Address - Country:US
Mailing Address - Phone:435-283-8400
Mailing Address - Fax:435-283-8401
Practice Address - Street 1:51 N CENTER ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:UT
Practice Address - Zip Code:84624-8430
Practice Address - Country:US
Practice Address - Phone:435-864-3073
Practice Address - Fax:435-864-3610
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT83330193502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health