1174850374 NPI number — MRS. TRISHA ROBINSON LPC

Table of content: MRS. TRISHA ROBINSON LPC (NPI 1174850374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174850374 NPI number — MRS. TRISHA ROBINSON LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINSON
Provider First Name:
TRISHA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BEHRENDS
Provider Other First Name:
TRISHA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174850374
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 21
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VERSAILLES
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65084-0021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-378-6833
Provider Business Mailing Address Fax Number:
573-378-6823

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 W JASPER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VERSAILLES
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65084-1020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-378-6833
Provider Business Practice Location Address Fax Number:
573-378-6823
Provider Enumeration Date:
11/09/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  2009006967 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)