Provider Demographics
NPI:1649598319
Name:DALEKE, ROBIN BENSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:BENSON
Last Name:DALEKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 KORNEGAY RD
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-7259
Mailing Address - Country:US
Mailing Address - Phone:662-609-1899
Mailing Address - Fax:
Practice Address - Street 1:2173 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5223
Practice Address - Country:US
Practice Address - Phone:662-234-6553
Practice Address - Fax:662-234-6556
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC55911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical