Provider Demographics
NPI:1700884236
Name:HORNE, ROBERT A (LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:HORNE
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 AUSTENWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-9180
Mailing Address - Country:US
Mailing Address - Phone:757-482-7928
Mailing Address - Fax:757-546-7361
Practice Address - Street 1:411 CEDAR RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-5566
Practice Address - Country:US
Practice Address - Phone:757-548-8848
Practice Address - Fax:757-549-1347
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001483101YP2500X
VA0717000280106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-0803-2Medicaid