Provider Demographics
NPI:1639163496
Name:TENNYSON, ROBYN RENEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:RENEE
Last Name:TENNYSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:29599 N 69TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-3177
Mailing Address - Country:US
Mailing Address - Phone:602-647-2783
Mailing Address - Fax:866-714-4031
Practice Address - Street 1:18185 N 83RD AVE
Practice Address - Street 2:SUITE D-201
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-0516
Practice Address - Country:US
Practice Address - Phone:800-626-1129
Practice Address - Fax:866-714-4031
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-101371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical