Provider Demographics
NPI:1669249454
Name:LUGO, ROBERT (LMHC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:LUGO
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 1:9527 N MAY APPLE DR
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-4405
Mailing Address - Country:US
Mailing Address - Phone:317-414-6471
Mailing Address - Fax:
Practice Address - Street 1:9527 N MAY APPLE DR
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-4405
Practice Address - Country:US
Practice Address - Phone:317-414-6471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000616A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health