Provider Demographics
NPI:1841799459
Name:MOORE-CHAMBERS, ROBIN S (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:S
Last Name:MOORE-CHAMBERS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11520 SAINT CHARLES ROCK RD STE 215
Mailing Address - Street 2:
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2732
Mailing Address - Country:US
Mailing Address - Phone:314-384-6940
Mailing Address - Fax:314-738-9696
Practice Address - Street 1:11520 SAINT CHARLES ROCK RD STE 215
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2732
Practice Address - Country:US
Practice Address - Phone:314-384-6940
Practice Address - Fax:314-738-9696
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-09
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018002374101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional