Provider Demographics
NPI:1992171821
Name:PIERCE, ROBERT (LCPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:PIERCE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N LORRAINE ST
Mailing Address - Street 2:STE 202
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67501-5670
Mailing Address - Country:US
Mailing Address - Phone:620-663-7595
Mailing Address - Fax:620-663-5263
Practice Address - Street 1:760 W D AVE
Practice Address - Street 2:STE 1
Practice Address - City:KINGMAN
Practice Address - State:KS
Practice Address - Zip Code:67068-1222
Practice Address - Country:US
Practice Address - Phone:620-532-3895
Practice Address - Fax:620-663-5263
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS129101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional