Provider Demographics
NPI:1699242974
Name:PLATT, ROBIN (LGPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:PLATT
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9006 WOODYARD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4206
Mailing Address - Country:US
Mailing Address - Phone:301-856-3636
Mailing Address - Fax:301-856-3633
Practice Address - Street 1:9006 WOODYARD RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4206
Practice Address - Country:US
Practice Address - Phone:301-856-3636
Practice Address - Fax:301-856-3633
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8882101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLGP8882OtherLICENSE