Provider Demographics
NPI:1609543727
Name:ROBISON, JOHN MATHEW (CBHPSS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MATHEW
Last Name:ROBISON
Suffix:
Gender:M
Credentials:CBHPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4412 BLUE DEVILS WAY APT 2
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3729
Mailing Address - Country:US
Mailing Address - Phone:406-970-0040
Mailing Address - Fax:
Practice Address - Street 1:1230 N. 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-5910
Practice Address - Country:US
Practice Address - Phone:406-534-4558
Practice Address - Fax:406-290-7450
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-BHPS-CRT-50085175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist