Provider Demographics
NPI:1861638553
Name:ROBINSON, ROGENNA L (LPC)
Entity Type:Individual
Prefix:
First Name:ROGENNA
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SANTA ANA AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:RANCHO VIEJO
Mailing Address - State:TX
Mailing Address - Zip Code:78575-9752
Mailing Address - Country:US
Mailing Address - Phone:956-621-3593
Mailing Address - Fax:956-621-3689
Practice Address - Street 1:200 SANTA ANA AVE APT 24
Practice Address - Street 2:
Practice Address - City:RANCHO VIEJO
Practice Address - State:TX
Practice Address - Zip Code:78575-9752
Practice Address - Country:US
Practice Address - Phone:956-621-3593
Practice Address - Fax:956-621-3689
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59817101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200743701Medicaid