Provider Demographics
NPI:1821154360
Name:VAN NESS, ROBIN RENE (CRC, LMHC)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:RENE
Last Name:VAN NESS
Suffix:
Gender:F
Credentials:CRC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122A UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1422
Mailing Address - Country:US
Mailing Address - Phone:646-391-0362
Mailing Address - Fax:
Practice Address - Street 1:122A UNION AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1422
Practice Address - Country:US
Practice Address - Phone:646-391-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001924101YM0800X
NY00013269101YP2500X
NY1821154360101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional