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Mr. Robert Glenn Lack III, MA,CDP
Addiction (Substance Use Disorder) Counselor in Kennewick, Washington
NPI 1386877389

Robert Glenn Lack III is an Addiction (Substance Use Disorder) Counselor based in Kennewick, WA and is specialized in Addiction (Substance Use Disorder). Robert Glenn Lack III practices in Kennewick, WA and has the professional credentials of MA,CDP. The NPI Number for Robert Glenn Lack III is 1386877389 and holds a License No. RC-00018500 (Washington).

The current practice location address for Robert Glenn Lack III is 1010 E Bruneau Ave, Kennewick, WA and can be reached out via phone at 509-735-7410 and via fax at 509-783-5953.

Location: 1010 E Bruneau Ave, Kennewick, WA, 99336-0697
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386877389
Provider Name
Robert Glenn Lack III
Credential
MA,CDP
Provider Entity Type
Individual
Gender
Male
Address
1010 E Bruneau Ave, Kennewick, WA, 99336-0697
Phone Number
509-735-7410
Fax Number
509-783-5953
Provider Enumeration Date
08/25/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1010 E Bruneau Ave
City
Kennewick
State
Washington
Zip
99336-3775
Phone Number
509-735-7410
Fax Number
509-783-5953
person
Provider Business Mailing Address Details
Address
1010 E Bruneau Ave
City
Kennewick
State
Washington
Zip
99336-3775
Phone Number
509-735-7410
Fax Number
509-783-5953
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
CP-00001417 (Washington)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
RC-00018500 (Washington)
Definition
Definition to come...
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