Provider Demographics
NPI:1134239973
Name:TOBIN, ROBIN ANN (MS,CRC,CADAC II,)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ANN
Last Name:TOBIN
Suffix:
Gender:F
Credentials:MS,CRC,CADAC II,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MA
Mailing Address - Zip Code:01083-0124
Mailing Address - Country:US
Mailing Address - Phone:413-436-9816
Mailing Address - Fax:
Practice Address - Street 1:72 JAQUES AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2476
Practice Address - Country:US
Practice Address - Phone:508-860-1083
Practice Address - Fax:508-860-1030
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA026715101Y00000X
MA0645AL101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0645ALMedicare ID - Type UnspecifiedCADAC II
MA026715Medicare ID - Type UnspecifiedCRC