Provider Demographics
NPI:1538121199
Name:MEADE, ROBIN C (PSYD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:C
Last Name:MEADE
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 LOUISIANA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-2344
Mailing Address - Country:US
Mailing Address - Phone:407-622-0825
Mailing Address - Fax:407-622-0826
Practice Address - Street 1:1215 LOUISIANA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2344
Practice Address - Country:US
Practice Address - Phone:407-622-0825
Practice Address - Fax:407-622-0826
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 3879101YM0800X
FLPY 6657103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health