MEDICARE: MR. ROBERT LASTEVE COGMON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518197953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT LASTEVE COGMON

Provider Business Mailing Address
First Line	:	2975 PAY LESS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-7443
Country	:	US
Telephone Number	:	702-576-2446
Fax Number	:	866-929-4542

Provider Business Practice Location Address
First Line	:	2975 PAY LESS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-7443
Country	:	US
Telephone Number	:	702-576-2446
Fax Number	:	866-929-4542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2009
Last Update Date	:	07/20/2009

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Directions to “ MR. ROBERT LASTEVE COGMON ” Practice Location

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