Healthcare Provider Details

I. General information

NPI: 1881434041
Provider Name (Legal Business Name): JODI LYNN ROBERTSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6025 FRANTZ RD
DUBLIN OH
43017-1302
US

IV. Provider business mailing address

1512 BAUER AVE
DAYTON OH
45420-3219
US

V. Phone/Fax

Practice location:
  • Phone: 614-948-3273
  • Fax: 855-740-2025
Mailing address:
  • Phone: 209-424-8245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2405843-TRNE
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2507139
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: