Provider Demographics
NPI:1588294672
Name:CHAUSTOWICH, ROBIN LYNN (MA, LPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:CHAUSTOWICH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39000 7 MILE RD STE 2300
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1006
Mailing Address - Country:US
Mailing Address - Phone:734-292-8589
Mailing Address - Fax:734-415-8427
Practice Address - Street 1:39000 7 MILE RD STE 2300
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1006
Practice Address - Country:US
Practice Address - Phone:734-292-8589
Practice Address - Fax:734-415-8427
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-17
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional