Provider Demographics
NPI:1568051134
Name:ROBINSON, RANDI D (LLPC)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:D
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1217
Mailing Address - Country:US
Mailing Address - Phone:248-991-2223
Mailing Address - Fax:
Practice Address - Street 1:485 PARK DR
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1217
Practice Address - Country:US
Practice Address - Phone:248-991-2223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional