Provider Demographics
NPI:1699538439
Name:HUME, ROBERT IAN (LPC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:IAN
Last Name:HUME
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 1:5898 W DEL LAGO CIR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6208
Mailing Address - Country:US
Mailing Address - Phone:480-848-4955
Mailing Address - Fax:
Practice Address - Street 1:5898 W DEL LAGO CIR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6208
Practice Address - Country:US
Practice Address - Phone:480-848-4955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20975101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor