Provider Demographics
NPI:1326003898
Name:ROBBINS, RODNEY (MA LPC, CADC III)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MA LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N EVEREST ST STE A
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2116
Mailing Address - Country:US
Mailing Address - Phone:503-538-7647
Mailing Address - Fax:503-538-9015
Practice Address - Street 1:120 N EVEREST ST STE A
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2116
Practice Address - Country:US
Practice Address - Phone:503-538-7647
Practice Address - Fax:503-538-9015
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR98-04-32101YA0400X
ORC4473101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC4473OtherLPC
OR98-04-32OtherCADC #
OR500709183Medicaid