Provider Demographics
NPI:1144376013
Name:ROBINSON, DANIEL MELTON (LCSW, LPC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:MELTON
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LCSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11437 S MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MO
Mailing Address - Zip Code:63841-9401
Mailing Address - Country:US
Mailing Address - Phone:573-624-6969
Mailing Address - Fax:573-624-5882
Practice Address - Street 1:11437 S MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MO
Practice Address - Zip Code:63841-9401
Practice Address - Country:US
Practice Address - Phone:573-624-6969
Practice Address - Fax:573-624-5882
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000238101YP2500X
MO0033451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202505OtherBLUE CROSS BLUE SHIELD