Provider Demographics
NPI:1477043420
Name:ROBISTOW, CAROLYN (MED, LPC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ROBISTOW
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 SAWDUST RD STE 1303
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2581
Mailing Address - Country:US
Mailing Address - Phone:713-202-1458
Mailing Address - Fax:
Practice Address - Street 1:2219 SAWDUST RD STE 1303
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2581
Practice Address - Country:US
Practice Address - Phone:713-202-1458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional