Provider Demographics
NPI:1780982934
Name:ENNIS, ROBIN (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:ENNIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:ENNIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:7887 E BELLEVIEW AVE STE 1100
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6097
Mailing Address - Country:US
Mailing Address - Phone:720-722-3981
Mailing Address - Fax:
Practice Address - Street 1:7887 E BELLEVIEW AVE STE 1100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6097
Practice Address - Country:US
Practice Address - Phone:720-722-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.09925611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty