Provider Demographics
NPI:1558559062
Name:LOTT, ROBERT DALE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DALE
Last Name:LOTT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 MISSISSIPPI AVE
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3851
Mailing Address - Country:US
Mailing Address - Phone:985-516-3298
Mailing Address - Fax:
Practice Address - Street 1:425 MISSISSIPPI AVE
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3851
Practice Address - Country:US
Practice Address - Phone:985-516-3298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical