Individual
MS. LORI ANNETTE ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LCAC
Contact information
Practice address
1810 DOGWOOD DR, KOKOMO, IN 46902-5737
(260) 274-0230
(260) 274-1500
Mailing address
1810 DOGWOOD DR, KOKOMO, IN 46902-5737
(260) 274-0230
(260) 274-1500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000744A
IN
1041C0700X
Clinical Social Worker
Primary
34005967A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14574
ICADC
IN
Enumeration date
06/28/2006
Last updated
07/07/2016
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