Provider Demographics
NPI:1417105792
Name:ROBINS, KENITH LEON (PHD)
Entity Type:Individual
Prefix:DR
First Name:KENITH
Middle Name:LEON
Last Name:ROBINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 SALEM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-5587
Mailing Address - Country:US
Mailing Address - Phone:615-310-1491
Mailing Address - Fax:615-848-0337
Practice Address - Street 1:2611 SALEM CREEK DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-5587
Practice Address - Country:US
Practice Address - Phone:615-310-1491
Practice Address - Fax:615-848-0337
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT326632-2501103TC0700X
TNP0000002879103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I689720Medicare PIN