Provider Demographics
NPI:1235407057
Name:HOSTETLER, ROBIN GAIL (LPCC-S)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:GAIL
Last Name:HOSTETLER
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-9001
Mailing Address - Country:US
Mailing Address - Phone:702-437-4673
Mailing Address - Fax:702-438-4673
Practice Address - Street 1:6600 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9001
Practice Address - Country:US
Practice Address - Phone:702-437-4673
Practice Address - Fax:702-438-4673
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0501217101YM0800X, 101YP2500X
NVCP1182-R101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH130910OtherMEDICARE GROUP PTAN
OH01-0693OtherCARF CERTIFICATION
OH0074861OtherMEDICAID-ODADAS
OH0074946OtherMEDICAID-ODMH