Individual
MR. ROBERT J LACKIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS MA ATR LPC MFT
Contact information
Practice address
6806 W 83RD ST, BROADMOOR MEDICAL BUILDING, OVERLAND PARK, KS 66204-3956
(913) 963-6850
Mailing address
6221 W 121ST TER, OVERLAND PARK, KS 66209-2576
(913) 469-6179
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1881
KS
101YM0800X
Mental Health Counselor
—
MO
106H00000X
Marriage & Family Therapist
113957
KS
106H00000X
Marriage & Family Therapist
113957
MO
221700000X
Art Therapist
14871
KS
221700000X
Art Therapist
14871
MO
Other
Enumeration date
06/27/2006
Last updated
10/22/2009
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