Provider Demographics
NPI:1811995871
Name:PRICE, ROBERT LEE (LPC-MHSP, MED, DCC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:LEE
Last Name:PRICE
Suffix:
Gender:M
Credentials:LPC-MHSP, MED, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 DUNHAM RD
Mailing Address - Street 2:
Mailing Address - City:CHUCKEY
Mailing Address - State:TN
Mailing Address - Zip Code:37641-6708
Mailing Address - Country:US
Mailing Address - Phone:423-741-7503
Mailing Address - Fax:
Practice Address - Street 1:900 DUNHAM RD
Practice Address - Street 2:
Practice Address - City:CHUCKEY
Practice Address - State:TN
Practice Address - Zip Code:37641-6708
Practice Address - Country:US
Practice Address - Phone:423-741-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY276719101YM0800X
TN1717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health