Provider Demographics
NPI:1285013193
Name:YOUNG, ROBIN MICHAEL (LMFT)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MICHAEL
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:MICHAEL
Other - Last Name:KNUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5100 TRINITY GATE LN
Mailing Address - Street 2:APT 205
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-3995
Mailing Address - Country:US
Mailing Address - Phone:760-450-4103
Mailing Address - Fax:
Practice Address - Street 1:5350 TOMAH DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6904
Practice Address - Country:US
Practice Address - Phone:970-310-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10045A106H00000X
CO0001723106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist