Provider Demographics
NPI:1457740821
Name:ROBSON, BRIANNE A (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:A
Last Name:ROBSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 S SCHUYLER AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3821
Mailing Address - Country:US
Mailing Address - Phone:815-641-9630
Mailing Address - Fax:815-304-4749
Practice Address - Street 1:187 S SCHUYLER AVE STE 410
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3821
Practice Address - Country:US
Practice Address - Phone:815-641-9630
Practice Address - Fax:815-304-4749
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0190171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical