Provider Demographics
NPI:1417109273
Name:ROBISON, RICHARD EDWIN (LCSW, CCDP, ACSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EDWIN
Last Name:ROBISON
Suffix:
Gender:M
Credentials:LCSW, CCDP, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5519
Mailing Address - Country:US
Mailing Address - Phone:717-652-5875
Mailing Address - Fax:717-652-7170
Practice Address - Street 1:1100 S CAMERON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-2547
Practice Address - Country:US
Practice Address - Phone:717-238-7662
Practice Address - Fax:717-238-7894
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health