Provider Demographics
NPI:1124357975
Name:ARCHER, ROBIN SUE (LPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SUE
Last Name:ARCHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 555
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-0555
Mailing Address - Country:US
Mailing Address - Phone:844-977-2847
Mailing Address - Fax:844-717-2847
Practice Address - Street 1:124 MEADVILLE ST STE 105
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2502
Practice Address - Country:US
Practice Address - Phone:844-977-2847
Practice Address - Fax:844-717-2847
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional