Provider Demographics
NPI:1508242132
Name:SPENCER, ROBIN L (LMFT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4374 KUKUI GROVE ST
Mailing Address - Street 2:STE 104
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-2007
Mailing Address - Country:US
Mailing Address - Phone:808-246-0663
Mailing Address - Fax:808-246-1806
Practice Address - Street 1:140 PUUEO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2429
Practice Address - Country:US
Practice Address - Phone:808-969-7577
Practice Address - Fax:808-934-0497
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1578-10101YA0400X
HIMFT288106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI288OtherLMFT
HI1578-10OtherCERTIFIED SUBSTANCE ABUSE COUNSELOR