Provider Demographics
NPI:1710635107
Name:PELLERIN, ROBIN LEWIS (LMHCA, LMFTA)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LEWIS
Last Name:PELLERIN
Suffix:
Gender:F
Credentials:LMHCA, LMFTA
Other - Prefix:
Other - First Name:ROBIN'S REFUGE
Other - Middle Name:COUNSELING
Other - Last Name:SERVICES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHCA, LMFTA
Mailing Address - Street 1:2118 212TH STREET CT E
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-7510
Mailing Address - Country:US
Mailing Address - Phone:253-861-5125
Mailing Address - Fax:
Practice Address - Street 1:2118 212TH STREET CT E
Practice Address - Street 2:
Practice Address - City:SPANAWAY
Practice Address - State:WA
Practice Address - Zip Code:98387-7510
Practice Address - Country:US
Practice Address - Phone:253-861-5125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61075573101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health