Provider Demographics
NPI:1538671409
Name:ROBINSON, THERESE (LCSW, CSAC)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 W THEODORE TRECKER WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-1135
Mailing Address - Country:US
Mailing Address - Phone:414-928-1401
Mailing Address - Fax:414-928-1402
Practice Address - Street 1:11390 W THEODORE TRECKER WAY
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-1135
Practice Address - Country:US
Practice Address - Phone:414-928-1401
Practice Address - Fax:414-928-1402
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YA0400X
WI102081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)