Provider Demographics
NPI:1720673072
Name:ROBINSON, KEVIN (LPC, LAC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 KENDALL ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-1412
Mailing Address - Country:US
Mailing Address - Phone:720-446-9213
Mailing Address - Fax:
Practice Address - Street 1:1651 KENDALL ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-1412
Practice Address - Country:US
Practice Address - Phone:720-446-9213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001840101YA0400X
COLPC.0015500101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)