Provider Demographics
NPI:1629215751
Name:GAY, ROBIN K (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:K
Last Name:GAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 NEPONSET ST FL STREET2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-856-0732
Mailing Address - Fax:508-425-5126
Practice Address - Street 1:225 NEW LANCASTER ROAD
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-4958
Practice Address - Country:US
Practice Address - Phone:508-856-0732
Practice Address - Fax:508-425-5126
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017404103G00000X, 103TC0700X, 103TP2701X, 103TR0400X
MA9844103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation