Provider Demographics
NPI:1477762367
Name:ROBINSON, SEAN A (LLPC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 EASTERN AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-3632
Mailing Address - Country:US
Mailing Address - Phone:616-988-3433
Mailing Address - Fax:616-233-0672
Practice Address - Street 1:2400 EASTERN AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49507-3632
Practice Address - Country:US
Practice Address - Phone:616-988-3433
Practice Address - Fax:313-899-7087
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009578101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor