Provider Demographics
NPI:1013250372
Name:QUILLIAM, ROBYN J (LMHC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:J
Last Name:QUILLIAM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 CHANDLER ST # 234
Mailing Address - Street 2:SUITE B
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-2940
Mailing Address - Country:US
Mailing Address - Phone:774-243-6295
Mailing Address - Fax:774-243-6294
Practice Address - Street 1:232 CHANDLER ST # 234
Practice Address - Street 2:SUITE B
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-2940
Practice Address - Country:US
Practice Address - Phone:774-243-6295
Practice Address - Fax:774-243-6294
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health