Provider Demographics
NPI:1801367651
Name:BLOCK, ROBIN GAYLE (LPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:GAYLE
Last Name:BLOCK
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9205 W CENTER ST STE 201
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-4548
Mailing Address - Country:US
Mailing Address - Phone:414-563-7341
Mailing Address - Fax:262-474-3659
Practice Address - Street 1:9205 W CENTER ST STE 201
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-4548
Practice Address - Country:US
Practice Address - Phone:414-563-7341
Practice Address - Fax:262-474-3659
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health