Provider Demographics
NPI:1285919134
Name:ROBINSON-ELLISON, BILLYE JO (BA, BHRS, CM, MED)
Entity type:Individual
Prefix:
First Name:BILLYE
Middle Name:JO
Last Name:ROBINSON-ELLISON
Suffix:
Gender:F
Credentials:BA, BHRS, CM, MED
Other - Prefix:
Other - First Name:B.J.
Other - Middle Name:
Other - Last Name:ROBINSON-ELLISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:3509 OVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2294
Mailing Address - Country:US
Mailing Address - Phone:580-513-2121
Mailing Address - Fax:580-498-0050
Practice Address - Street 1:3509 OVERLAND DR
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2294
Practice Address - Country:US
Practice Address - Phone:580-513-2121
Practice Address - Fax:580-498-0050
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool