Provider Demographics
NPI:1457898231
Name:ROBINSON, NICHOLAS E
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:E
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:NICK
Other - Middle Name:E
Other - Last Name:RONINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3311 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-6107
Mailing Address - Country:US
Mailing Address - Phone:888-332-1530
Mailing Address - Fax:918-289-0657
Practice Address - Street 1:3311 E 30TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-6107
Practice Address - Country:US
Practice Address - Phone:888-332-1530
Practice Address - Fax:918-289-0657
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No251S00000XAgenciesCommunity/Behavioral Health