Provider Demographics
NPI:1952811176
Name:JAMES, ROBIN K (LMHC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:K
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:K
Other - Last Name:LILLIEDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-1406
Mailing Address - Country:US
Mailing Address - Phone:260-421-5000
Mailing Address - Fax:260-421-5003
Practice Address - Street 1:500 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-1406
Practice Address - Country:US
Practice Address - Phone:260-421-5000
Practice Address - Fax:260-421-5003
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002605A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health