Provider Demographics
NPI:1104243161
Name:RASSE, ROBIN R (MED, LPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:RASSE
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:RENE'
Other - Last Name:RASSE-COTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1300 E BRADFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4264
Mailing Address - Country:US
Mailing Address - Phone:417-761-5000
Mailing Address - Fax:417-761-5065
Practice Address - Street 1:33 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MO
Practice Address - Zip Code:65340
Practice Address - Country:US
Practice Address - Phone:660-886-8063
Practice Address - Fax:660-263-2815
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012026707101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490012876Medicaid