Healthcare Provider Details

I. General information

NPI: 1164953105
Provider Name (Legal Business Name): DOTY M ROBBINS MSW, LICSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 W 6TH ST STE 208
MOSCOW ID
83843-2387
US

IV. Provider business mailing address

317 W 6TH ST STE 208
MOSCOW ID
83843-2387
US

V. Phone/Fax

Practice location:
  • Phone: 208-882-3504
  • Fax:
Mailing address:
  • Phone: 82-088-8235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW61284003
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW42346
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: