Provider Demographics
NPI:1154503365
Name:CHAMBERLAIN, ROBIN J (DMIN, LCPC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:J
Last Name:CHAMBERLAIN
Suffix:
Gender:F
Credentials:DMIN, LCPC
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 93
Mailing Address - Street 2:201 ROUTE 1
Mailing Address - City:WHITING
Mailing Address - State:ME
Mailing Address - Zip Code:04691-0093
Mailing Address - Country:US
Mailing Address - Phone:207-263-5530
Mailing Address - Fax:
Practice Address - Street 1:201 ROUTE 1
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:ME
Practice Address - Zip Code:04691
Practice Address - Country:US
Practice Address - Phone:207-263-5530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2579101YP2500X
IL1880002587101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional