Provider Demographics
NPI:1326417130
Name:GILMORE, ROBYN KEEGAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:KEEGAN
Last Name:GILMORE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:EILEEN
Other - Last Name:KEEGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 395
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70722-0395
Mailing Address - Country:US
Mailing Address - Phone:225-683-5292
Mailing Address - Fax:225-683-1310
Practice Address - Street 1:203 ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-3219
Practice Address - Country:US
Practice Address - Phone:225-389-1311
Practice Address - Fax:225-389-1330
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA104100000X
LA127841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker