Provider Demographics
NPI:1497061675
Name:ROBBINS, DAVID P (MA/LPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:P
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:MA/LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 BURMINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MO
Mailing Address - Zip Code:65653-5681
Mailing Address - Country:US
Mailing Address - Phone:816-396-0181
Mailing Address - Fax:816-396-0181
Practice Address - Street 1:721 BURMINGHAM RD
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MO
Practice Address - Zip Code:65653-5681
Practice Address - Country:US
Practice Address - Phone:816-396-0181
Practice Address - Fax:816-396-0181
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YM0800X
MO2010029389101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2233OtherLAC-LICENSED ADDICTION COUNSELOR