Provider Demographics
NPI:1609923788
Name:WITHROW, ROBIN (LCPC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WITHROW
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 MARKETVIEW DR # 193
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1896
Mailing Address - Country:US
Mailing Address - Phone:630-707-6029
Mailing Address - Fax:
Practice Address - Street 1:215 HILLCREST AVE STE E
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1366
Practice Address - Country:US
Practice Address - Phone:630-707-6029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005551101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2220936OtherBCBS