Provider Demographics
NPI:1932547692
Name:FATE, ROBIN LEE (MS, LPCC)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:LEE
Last Name:FATE
Suffix:
Gender:M
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 SAINT CROIX TRL S
Mailing Address - Street 2:ST. CROIX BUSINESS CENTER, SUITE 155
Mailing Address - City:LAKELAND
Mailing Address - State:MN
Mailing Address - Zip Code:55043-8404
Mailing Address - Country:US
Mailing Address - Phone:651-431-8846
Mailing Address - Fax:
Practice Address - Street 1:44 SAINT CROIX TRL S
Practice Address - Street 2:ST. CROIX BUSINESS CENTER, SUITE 155
Practice Address - City:LAKELAND
Practice Address - State:MN
Practice Address - Zip Code:55043-8404
Practice Address - Country:US
Practice Address - Phone:651-431-8846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00920101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional