MEDICARE: ROBIN CRISP LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	734	MT

General Provider Information

NPI Number	:	1790006054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN CRISP LCPC

Provider Business Mailing Address
First Line	:	6479 US HIGHWAY 93 S # 360
Second Line	:
City	:	WHITEFISH
State	:	MT
Zip	:	59937-8238
Country	:	US
Telephone Number	:	406-250-2056
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 E WASHINGTON ST
Second Line	:	SUITE A
City	:	KALISPELL
State	:	MT
Zip	:	59901-3968
Country	:	US
Telephone Number	:	406-260-3395
Fax Number	:	406-752-8849

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2010
Last Update Date	:	02/10/2025

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