Provider Demographics
NPI:1427381987
Name:ROBINSON, LEE MARVIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:MARVIN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 CHIMNEY ROCK RD
Mailing Address - Street 2:
Mailing Address - City:EVERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:76140-4704
Mailing Address - Country:US
Mailing Address - Phone:817-551-1756
Mailing Address - Fax:817-336-4026
Practice Address - Street 1:504 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:EVERMAN
Practice Address - State:TX
Practice Address - Zip Code:76140-4704
Practice Address - Country:US
Practice Address - Phone:817-551-1756
Practice Address - Fax:817-336-4026
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6659101YA0400X
TX58137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)