Provider Demographics
NPI:1033886924
Name:ROBINSON, DOUGLAS P (MA LMFT)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:P
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 COON RAPIDS BLVD NW STE 306
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-5861
Mailing Address - Country:US
Mailing Address - Phone:763-780-1520
Mailing Address - Fax:
Practice Address - Street 1:199 COON RAPIDS BLVD NW STE 306
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5861
Practice Address - Country:US
Practice Address - Phone:763-780-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3248106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist