Provider Demographics
NPI:1427345164
Name:MUCARIA, ROBIN (LLPC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:
Last Name:MUCARIA
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:MUCARIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLPC
Mailing Address - Street 1:4260 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6230
Mailing Address - Country:US
Mailing Address - Phone:248-953-4273
Mailing Address - Fax:248-307-0433
Practice Address - Street 1:100 JOHN R SUITE 113
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-6230
Practice Address - Country:US
Practice Address - Phone:248-953-4273
Practice Address - Fax:248-307-0433
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2002553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health