Provider Demographics
NPI:1275051005
Name:ROBINSON, KENYA JACOBIE DEQUANE (LPC)
Entity Type:Individual
Prefix:
First Name:KENYA JACOBIE
Middle Name:DEQUANE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7510 FM 1886
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-1054
Mailing Address - Country:US
Mailing Address - Phone:817-448-8881
Mailing Address - Fax:
Practice Address - Street 1:7510 FM 1886
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-1054
Practice Address - Country:US
Practice Address - Phone:817-448-8881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75098101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)