Provider Demographics
NPI:1710906151
Name:LOUZAN, ROBERT (LMHC)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:LOUZAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:E FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-4711
Mailing Address - Country:US
Mailing Address - Phone:508-274-2587
Mailing Address - Fax:
Practice Address - Street 1:2 COLUMBIA RD
Practice Address - Street 2:SUITE #8
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1842
Practice Address - Country:US
Practice Address - Phone:781-826-7940
Practice Address - Fax:781-826-7940
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALM0234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM0234OtherINSURANCE PROVIDER NUMBER