Provider Demographics
NPI:1215390059
Name:PEE, ROBIN BRYANT (LPC-S)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:BRYANT
Last Name:PEE
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E ADAMS ST OFC A
Mailing Address - Street 2:
Mailing Address - City:KOSCIUSKO
Mailing Address - State:MS
Mailing Address - Zip Code:39090-3706
Mailing Address - Country:US
Mailing Address - Phone:662-582-0126
Mailing Address - Fax:
Practice Address - Street 1:400 E ADAMS ST OFC A
Practice Address - Street 2:
Practice Address - City:KOSCIUSKO
Practice Address - State:MS
Practice Address - Zip Code:39090-3706
Practice Address - Country:US
Practice Address - Phone:662-582-0126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2202101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01439013Medicaid