Provider Demographics
NPI:1851324701
Name:MCLEOD, ROBIN (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7582 CURRELL BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2262
Mailing Address - Country:US
Mailing Address - Phone:651-739-7539
Mailing Address - Fax:651-739-9200
Practice Address - Street 1:7582 CURRELL BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2262
Practice Address - Country:US
Practice Address - Phone:651-739-7539
Practice Address - Fax:651-739-9200
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3073103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN778216100Medicaid
MN778216100Medicaid