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ROBERT FANE AGENCY LLCP NPI 1639341126


NPI Information

NPI: 1639341126
Provider Name: ROBERT FANE AGENCY, LLCP
Classification: Psychologist - 103TC2200X
Entity Type: Organization

Specialization: Clinical Child & Adolescent

Address:
1011 LEHMAN AVE
SUITE 103
BOWLING GREEN, KY
ZIP 42103
Phone: (270) 393-9833
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ROBERT FANE AGENCY, LLCP is a clinical child and adolescent psychologist in Bowling Green, KY. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. ROBERT FANE AGENCY, LLCP NPI is 1639341126. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1011 LEHMAN AVE
SUITE 103
BOWLING GREEN, KY
ZIP 42103-515
Phone: (270) 393-9833
Fax: (270) 393-9835

The provider's authorized official is Robert Bruce Fane .
The authorized official title is Owner and has the following contact phone number (270) 393-9833.

The enumeration date for this NPI number is 3/25/2008 and was last updated on 10/21/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC2200XPsychologistClinical Child & Adolescent1104KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
129200912MEDICAIDKENTUCKY
229100914MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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