Provider Demographics
NPI:1528453131
Name:BARBARA ROBINSON LCSW
Entity type:Organization
Organization Name:BARBARA ROBINSON LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-612-2272
Mailing Address - Street 1:1820 E 17TH ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6469
Mailing Address - Country:US
Mailing Address - Phone:208-528-7566
Mailing Address - Fax:
Practice Address - Street 1:3670 S 25TH E
Practice Address - Street 2:SUITE 2D
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-4956
Practice Address - Country:US
Practice Address - Phone:208-612-2272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty