Healthcare Provider Details

I. General information

NPI: 1205434230
Provider Name (Legal Business Name): KATHLEEN E ROBBINS RN, LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE ROBBINS

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 ONE DEERFIELD PL UNIT K411
MASON OH
45040-3531
US

IV. Provider business mailing address

9250 ONE DEERFIELD PL UNIT K411
MASON OH
45040-3531
US

V. Phone/Fax

Practice location:
  • Phone: 513-465-7612
  • Fax:
Mailing address:
  • Phone: 513-465-7612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN.462358
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.1000102-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: