Provider Demographics
NPI:1205800737
Name:ROBINSON, RICHARD STUART (LCSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:STUART
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84105-2617
Mailing Address - Country:US
Mailing Address - Phone:801-583-4903
Mailing Address - Fax:
Practice Address - Street 1:1753 SIDEWINDER DR
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84060-7258
Practice Address - Country:US
Practice Address - Phone:435-479-9079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT350585-3501101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT103TP2700XOtherPSYCHOTHERAPY