| Robert Dale Lott | |
|
425 Mississippi Ave. Bogalusa LA 70427 | |
| (985) 516-3298 | |
| (504) 309-7845 |
| Full Name | Robert Dale Lott |
|---|---|
| Speciality | Social Worker |
| Location | 425 Mississippi Ave., Bogalusa, Louisiana |
| Authorized Official Name and Position | Robert Dale Lott (LCSW/OWNER) |
| Authorized Official Contact | 9855163298 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert Dale Lott 425 Mississippi Ave. Bogalusa LA 70427 Ph: (985) 516-3298 | Robert Dale Lott 425 Mississippi Ave. Bogalusa LA 70427 Ph: (985) 516-3298 |
| NPI Number | 1467235168 |
|---|---|
| Provider Enumeration Date | 08/16/2023 |
| Last Update Date | 08/16/2023 |
| Medicare PECOS PAC ID | 1658726369 |
|---|---|
| Medicare Enrollment ID | O20231016003509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467235168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robert D Lott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558559062 PECOS PAC ID: 1355759838 Enrollment ID: I20231101000254 |
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