Provider Demographics
NPI:1063665776
Name:WELK-RICHARDS, ROBYN MICHELLE (PHD, MSW, LCSW, CEDS)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:MICHELLE
Last Name:WELK-RICHARDS
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW, CEDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 ELM GROVE RD # 100
Mailing Address - Street 2:
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-2528
Mailing Address - Country:US
Mailing Address - Phone:262-352-9922
Mailing Address - Fax:
Practice Address - Street 1:890 ELM GROVE RD # 100
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-2528
Practice Address - Country:US
Practice Address - Phone:262-352-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-25
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI123.7428104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker