Provider Demographics
NPI:1164077517
Name:ROBERTSON, MARCIE LYNN (LSCSW)
Entity Type:Individual
Prefix:
First Name:MARCIE
Middle Name:LYNN
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 ANDERSON AVE STE D110
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-7603
Mailing Address - Country:US
Mailing Address - Phone:785-539-5455
Mailing Address - Fax:785-776-7570
Practice Address - Street 1:4201 ANDERSON AVE STE D110
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66503-7603
Practice Address - Country:US
Practice Address - Phone:785-539-5455
Practice Address - Fax:785-776-7570
Is Sole Proprietor?:No
Enumeration Date:2019-08-02
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical