Provider Demographics
NPI:1013625409
Name:ROBINSON, KELLY JAMES (PSYD, LPA-IP)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:JAMES
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PSYD, LPA-IP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 KATHRYN LN APT 3125
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6488
Mailing Address - Country:US
Mailing Address - Phone:325-374-4253
Mailing Address - Fax:
Practice Address - Street 1:6371 PRESTON RD STE 120
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9297
Practice Address - Country:US
Practice Address - Phone:325-374-4253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37842103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical