Provider Demographics
NPI:1154004851
Name:CALLAGHAN, ROBIN LEE
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LEE
Last Name:CALLAGHAN
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 1:100 N D ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97630-1552
Mailing Address - Country:US
Mailing Address - Phone:541-947-6021
Mailing Address - Fax:
Practice Address - Street 1:100 N D ST STE 100
Practice Address - Street 2:
Practice Address - City:LAKEVIEW
Practice Address - State:OR
Practice Address - Zip Code:97630-1552
Practice Address - Country:US
Practice Address - Phone:541-947-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator