Provider Demographics
NPI:1053900613
Name:ROBINSON, LYNN SUSAN
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:SUSAN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15854 JACKSON CREEK PKWY UNIT 120
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8663
Mailing Address - Country:US
Mailing Address - Phone:719-364-9930
Mailing Address - Fax:719-364-9939
Practice Address - Street 1:15854 JACKSON CREEK PKWY UNIT 120
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8663
Practice Address - Country:US
Practice Address - Phone:719-364-9930
Practice Address - Fax:719-364-9939
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099263391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical