Provider Demographics
NPI:1306655964
Name:REIKES, ROBIN LYNN (LAC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:REIKES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N WESTERN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1448
Mailing Address - Country:US
Mailing Address - Phone:502-727-2323
Mailing Address - Fax:
Practice Address - Street 1:18 OLIVER ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3620
Practice Address - Country:US
Practice Address - Phone:973-329-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00768500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health