Healthcare Provider Details

I. General information

NPI: 1356208599
Provider Name (Legal Business Name): BETH ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/31/2026
Certification Date: 01/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17835 NAVAJO TRCE
TINLEY PARK IL
60477-7897
US

IV. Provider business mailing address

300 LACEBARK ST
SCHERERVILLE IN
46375-4343
US

V. Phone/Fax

Practice location:
  • Phone: 219-209-2159
  • Fax:
Mailing address:
  • Phone: 219-209-2159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.021884
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2507569
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number88002767A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: