Provider Demographics
NPI:1144744459
Name:COUGHLIN, ROBIN (LPC-MHSP, CRC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:COUGHLIN
Suffix:
Gender:F
Credentials:LPC-MHSP, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6553 HONEYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7817
Mailing Address - Country:US
Mailing Address - Phone:601-575-6021
Mailing Address - Fax:
Practice Address - Street 1:6553 HONEYBROOK RD.
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134
Practice Address - Country:US
Practice Address - Phone:601-575-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3892101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional