Provider Demographics
NPI:1255111688
Name:RISTENBATT, ROBIN MCCOOL (LCSW/C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MCCOOL
Last Name:RISTENBATT
Suffix:
Gender:F
Credentials:LCSW/C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 APPLE LN
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-4161
Mailing Address - Country:US
Mailing Address - Phone:410-693-6700
Mailing Address - Fax:
Practice Address - Street 1:2 APPLE LN
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-4161
Practice Address - Country:US
Practice Address - Phone:410-693-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD063321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical