Provider Demographics
NPI:1154560456
Name:SLATER, ROBIN L (LPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:SLATER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:L
Other - Last Name:WISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81402-1208
Mailing Address - Country:US
Mailing Address - Phone:970-252-3200
Mailing Address - Fax:970-252-3208
Practice Address - Street 1:2130 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-3834
Practice Address - Country:US
Practice Address - Phone:970-252-3200
Practice Address - Fax:970-252-3208
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
COLPC0012164101YP2500X
COACD0000241101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)