Healthcare Provider Details

I. General information

NPI: 1952951519
Provider Name (Legal Business Name): ALYSSA ANORA ROBINSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2019
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N 8TH ST STE 4
SAINT MARIES ID
83861-1869
US

IV. Provider business mailing address

1250 W IRONWOOD DR STE 330
COEUR D ALENE ID
83814-2682
US

V. Phone/Fax

Practice location:
  • Phone: 208-597-7639
  • Fax:
Mailing address:
  • Phone: 208-620-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLAMFT-7179
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-9624
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: