MR. ROBERT GLENN LACK III (NPI# 1386877389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386877389 |
| Entity Type | Individual |
| Full Name | MR. ROBERT GLENN LACK III |
| Credential | MA, CDP |
| Practice Address |
1010 E Bruneau Ave Kennewick WA 99336-3775 |
| Mailing Address |
Po Box 5697 Kennewick WA 99336-0697 |
| Practice Telephone | 5097357410 |
| Practice Fax Number | 5097835953 |
| Mailing Telephone | 5097357410 |
| Mailing Fax Number | 5097835953 |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2009-08-25 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | RC-00018500 | WA | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CP-00001417 | WA | Behavioral Health & Social Service Providers |
| Street Address |
1010 E BRUNEAU AVE |
| City | KENNEWICK |
| State | WA |
| Zip Code | 99336-3775 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922356906 | Action Counseling | Counselor | 1010 E Bruneau Ave, Kennewick, WA 99336-3775 | 2012-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497393888 | Kelsie D Parvinen | Massage Therapist | 8350 W. Grandridge Blvd, Suite 100, Kennewick, WA 99336 | 2019-12-16 |
| 1508403858 | New U Women's Clinic & Aesthetics Pllc | Nurse Practitioner | 35 S Louisiana St, Suite A120, Kennewick, WA 99336 | 2019-12-05 |
| 1457901944 | Solar Mobility LLC | Durable Medical Equipment & Medical Supplies | 949 S Keller St, Kennewick, WA 99336 | 2019-09-17 |
| 1023662590 | Shane Arthur Gulley | Counselor | 500 N. Morain St Suite 1250, Kennewick, WA 99336 | 2019-08-01 |
| 1063973873 | Farah Saleem | Student in an Organized Health Care Education/Training Program | 212 W. 10th Avenue,suite 202, Kennewick, WA 99336 | 2019-03-26 |
| 1255897690 | Thomas Stanley Mcgowan | Student in an Organized Health Care Education/Training Program | Tri-cities Cancer Center, 7350 W. Deschutes Ave, Building A, Kennewick, WA 99336 | 2019-02-11 |
| 1770068280 | Remedy Urgent Mobile Medicine Pllc | Nurse Practitioner | 3311 West Clearwater Avenue, Suite D210, Kennewick, WA 99336 | 2018-10-01 |
| 1740767011 | Zachary Wilber Fournier | Specialist/Technologist | Toyota Center - 7000 West Grandridge Blvd, Kennewick, WA 99336 | 2018-07-19 |
| 1649780693 | Alan Arnold Hanson | Chiropractor | 8350 W. Grandridge Blvd #100, Kennewick, WA 99336 | 2017-10-04 |
| 1922528827 | Sarah Nicole Childress | Counselor | 415 North Morain St, Kennewick, WA 99336 | 2017-06-21 |
| Find all providers in zip 99336 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699321745 | Steve R Ouradnik | Counselor | 3703 W Kennewick Ave Apt D326, Kennewick, WA 99336-2883 | 2019-08-14 |
| 1922528827 | Sarah Nicole Childress | Counselor | 415 North Morain St, Kennewick, WA 99336 | 2017-06-21 |
| 1659732477 | Jennifer Heston | Counselor | 1914 W 2nd Ave, Kennewick, WA 99336-3248 | 2016-03-08 |
| 1134599384 | Pattrisha Pesina | Counselor | 7510 W Deschutes Pl, Kennewick, WA 99336 | 2015-09-30 |
| 1902286834 | Minghua Zhu | Counselor | 274 N Hawaii St, Kennewick, WA 99336-1682 | 2015-06-05 |
| 1780011627 | Monica Lynn Ottum | Counselor | 415 N. Morain Street, Kennewick, WA 99336 | 2013-10-10 |
| 1053646026 | Valerie Joanne Engel | Counselor | 200 S Union St Apt 2b, Kennewick, WA 99336-2275 | 2009-10-08 |
| 1821273202 | Clifton Watson Jr. | Counselor | 303 1/2 W Kennewick Ave # Wa, Kennewick, WA 99336-3858 | 2008-01-04 |
| 1972700102 | Deana Rae Mcglothlin | Counselor | 1614 S Fruitland St, Kennewick, WA 99337-4841 | 2007-06-29 |
| 1518162411 | Sari Elaine Anderson | Counselor | 5504 W Metaline Ave, Kennewick, WA 99336-1419 | 2007-06-19 |
| Find all providers in KENNEWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.