Provider Demographics
NPI:1083044655
Name:ROSSOW, ROBIN NOEL GRINAGER (MS, NCC, LPC-MH)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:NOEL GRINAGER
Last Name:ROSSOW
Suffix:
Gender:F
Credentials:MS, NCC, LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 W 57TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3146
Mailing Address - Country:US
Mailing Address - Phone:605-250-1226
Mailing Address - Fax:
Practice Address - Street 1:3220 W 57TH ST STE 111
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-3146
Practice Address - Country:US
Practice Address - Phone:605-250-1226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH20313101YM0800X
SD7361101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health