Provider Demographics
NPI:1184830119
Name:ROBISON, CRAIG BRUCE (LPC,LMFT)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:BRUCE
Last Name:ROBISON
Suffix:
Gender:M
Credentials:LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3035 NW 63RD ST
Mailing Address - Street 2:202
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-3632
Mailing Address - Country:US
Mailing Address - Phone:405-747-6413
Mailing Address - Fax:
Practice Address - Street 1:3035 NW 63RD ST
Practice Address - Street 2:202
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3632
Practice Address - Country:US
Practice Address - Phone:405-747-6413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LPC 118101YP2500X
OKLMFT 053106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist