Provider Demographics
NPI:1922048834
Name:RAMBO, ROBERT S (LPC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:RAMBO
Suffix:
Gender:M
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:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609
Mailing Address - Country:US
Mailing Address - Phone:276-964-6702
Mailing Address - Fax:276-964-5669
Practice Address - Street 1:526 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:VA
Practice Address - Zip Code:24651
Practice Address - Country:US
Practice Address - Phone:276-988-7961
Practice Address - Fax:276-988-0081
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA257946OtherBCBS
VA235018OtherBCBS