Provider Demographics
NPI:1417512591
Name:ROBENS, SUSAN (MA/MS LPC ASSOC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:ROBENS
Suffix:
Gender:F
Credentials:MA/MS LPC ASSOC
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:SUSAN
Other - Last Name:ROBENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15405 SW 116TH AVE STE 202A
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97224-2600
Mailing Address - Country:US
Mailing Address - Phone:505-615-6176
Mailing Address - Fax:
Practice Address - Street 1:15405 SW 116TH AVE STE 202A
Practice Address - Street 2:
Practice Address - City:KING CITY
Practice Address - State:OR
Practice Address - Zip Code:97224-2600
Practice Address - Country:US
Practice Address - Phone:503-495-5072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-05
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR6595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health