Provider Demographics
NPI:1629423496
Name:ROBINSON, NANCY MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 N THOMPSON DR APT 1
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-1737
Mailing Address - Country:US
Mailing Address - Phone:731-293-4317
Mailing Address - Fax:
Practice Address - Street 1:409 N THOMPSON DR APT 1
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1737
Practice Address - Country:US
Practice Address - Phone:731-293-4317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1239-124106H00000X
GAMFT001697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty