Provider Demographics
NPI:1053025726
Name:WERNER, ROBERT STEPHEN (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEPHEN
Last Name:WERNER
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 1:113 POLLY CT
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2719
Mailing Address - Country:US
Mailing Address - Phone:706-338-4719
Mailing Address - Fax:
Practice Address - Street 1:113 POLLY CT
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2719
Practice Address - Country:US
Practice Address - Phone:706-338-4719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health