Provider Demographics
NPI:1942901608
Name:BUCK, ROBIN JANELLE (LMHCA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:JANELLE
Last Name:BUCK
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 JADWIN AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-3430
Mailing Address - Country:US
Mailing Address - Phone:509-366-8041
Mailing Address - Fax:
Practice Address - Street 1:1201 JADWIN AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3429
Practice Address - Country:US
Practice Address - Phone:509-366-8041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60772748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health