Healthcare Provider Details

I. General information

NPI: 1144229675
Provider Name (Legal Business Name): MINDI L ROBINSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2325 Q ST
BEDFORD IN
47421-4718
US

IV. Provider business mailing address

2325 Q ST
BEDFORD IN
47421-4718
US

V. Phone/Fax

Practice location:
  • Phone: 812-279-4673
  • Fax: 812-279-4672
Mailing address:
  • Phone: 812-279-4673
  • Fax: 812-279-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number340004943A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: