Provider Demographics
NPI:1992747828
Name:ROBISON, REBECCA ANN (LCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:ROBISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 EUGENE FIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64505-2228
Mailing Address - Country:US
Mailing Address - Phone:816-279-6157
Mailing Address - Fax:816-233-4963
Practice Address - Street 1:2404 HIGHLY ST
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-2729
Practice Address - Country:US
Practice Address - Phone:816-279-6157
Practice Address - Fax:816-233-4963
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO761101YA0400X
MO000609101YP2500X
MO0014041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical