Provider Demographics
NPI:1669862686
Name:MATHEWS, ROBIN (LMFT)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MATHEWS
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 1:400 TAMIAMI TRL S STE 160
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2612
Mailing Address - Country:US
Mailing Address - Phone:559-258-2929
Mailing Address - Fax:
Practice Address - Street 1:400 TAMIAMI TRL S STE 160
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2612
Practice Address - Country:US
Practice Address - Phone:559-258-2929
Practice Address - Fax:559-570-0146
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT42356106H00000X
FLMT4602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist