Provider Demographics
NPI:1902316227
Name:WEST, ROBIN M (MSW, CAPSW, CSAC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:M
Last Name:WEST
Suffix:
Gender:F
Credentials:MSW, CAPSW, CSAC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:KONETZKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, CAPSW, CSAC
Mailing Address - Street 1:1715 ALGOMA BLVD
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54901-2724
Mailing Address - Country:US
Mailing Address - Phone:920-216-5078
Mailing Address - Fax:920-216-5078
Practice Address - Street 1:1715 ALGOMA BLVD
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-2724
Practice Address - Country:US
Practice Address - Phone:920-216-5078
Practice Address - Fax:920-216-5078
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15989-132101YA0400X
WI8918-1231041C0700X
WI128991-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical