Provider Demographics
NPI:1508126087
Name:ROBBINS, MICHELLE LORICK (LCPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LORICK
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 KATIE LN
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-5535
Mailing Address - Country:US
Mailing Address - Phone:207-837-4416
Mailing Address - Fax:
Practice Address - Street 1:31 KATIE LN
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-5535
Practice Address - Country:US
Practice Address - Phone:803-629-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC6225101YP2500X
SC6475101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCW87474SC1Medicaid