Provider Demographics
NPI:1205434230
Name:ROBBINS, KATHLEEN E (RN, LISW-S)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:RN, LISW-S
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:ROBBINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9250 ONE DEERFIELD PL UNIT K411
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-3531
Mailing Address - Country:US
Mailing Address - Phone:513-465-7612
Mailing Address - Fax:
Practice Address - Street 1:9250 ONE DEERFIELD PL UNIT K411
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-3531
Practice Address - Country:US
Practice Address - Phone:513-465-7612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.462358163WP0808X
OHI.1000102-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2910854Medicaid