Provider Demographics
NPI:1225440142
Name:ROBINSON, SANDRA (LMHC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMHC
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 39098
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98496-3098
Mailing Address - Country:US
Mailing Address - Phone:253-376-7082
Mailing Address - Fax:
Practice Address - Street 1:4115 S MERIDIAN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-5972
Practice Address - Country:US
Practice Address - Phone:253-376-7082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60440426101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACMSMedicaid
WACMSMedicare UPIN
WACMSMedicare PIN