Lori Annette Robertson, LCSW, LCAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005967A Issued in IN

Practice address

1810 Dogwood Dr
Kokomo, IN 46902-5737

Phone

(260) 274-0230

Fax

(260) 274-1500

NPI assigned

Jun 28, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Lori Annette Coffey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467849600000",
    "number": "1124056460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 DOGWOOD DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469025737",
            "telephone_number": "260-274-0230",
            "fax_number": "260-274-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 DOGWOOD DR",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469025737",
            "telephone_number": "260-274-0230",
            "fax_number": "260-274-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "LORI",
        "middle_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005967A",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87000744A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ICADC",
            "identifier": "14574",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "COFFEY",
            "middle_name": "ANNETTE",
            "prefix": "MS.",
            "credential": "LCSW, LCAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roberts Dental Group LLC
• Amanda Roberts, PMHNP
• Justin L Roberts, D.D.S.
• Lindsey Carol Roberts, FNP
• Paul Joseph Roberts, PH.D.
• James Robinson, RPT
• Makayla Lee Robison
• Madison Rodabaugh
• Jamie Susan Rosalva Rodriguez, LMHC-A
• Kimberly Ann Roe, H.A.D.

• Clinical Social Worker in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.