Provider Demographics
NPI:1225659568
Name:ROBINSON, THERESA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:LYNN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7379 POPPY DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8917
Mailing Address - Country:US
Mailing Address - Phone:610-509-6910
Mailing Address - Fax:
Practice Address - Street 1:7379 POPPY DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8917
Practice Address - Country:US
Practice Address - Phone:610-509-6910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional