Basic Information
| Provider Information | |||||||||
| NPI: | 1528453131 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BARBARA ROBINSON LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1820 E 17TH ST | ||||||||
| Address2: | SUITE 330 | ||||||||
| City: | IDAHO FALLS | ||||||||
| State: | ID | ||||||||
| PostalCode: | 834046469 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2085287566 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3670 S 25TH E | ||||||||
| Address2: | SUITE 2D | ||||||||
| City: | IDAHO FALLS | ||||||||
| State: | ID | ||||||||
| PostalCode: | 834044956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2086122272 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2015 | ||||||||
| LastUpdateDate: | 03/31/2015 | ||||||||
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| AuthorizedOfficialLastName: | ROBINSON | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2086122272 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor |
No ID Information.