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General NPI Number Information
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NPI Number | 1427460229
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Entity Type | Individual
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Provider Name | ROBERT LOCK L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 08/01/2019
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Provider Practice Location Address
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Address Line | HINDS BEHAVIORAL HEALTH SERVICES 3450 HWY 80 W
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City | JACKSON
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State | MS
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Zip | 39209-4443
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Country | US
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Telephone | 601-321-2400
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Fax | 601-985-5174
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Provider Business Mailing Address
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Address Line | 828 BULLRUN CIR
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City | BYRAM
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State | MS
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Zip | 39272-4443
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Country | US
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Telephone | 601-519-1011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1861
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License Number State | MS
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