Healthcare Provider Details

I. General information

NPI: 1891998746
Provider Name (Legal Business Name): ANNA M ROBBINS M.ED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 E MAIN ST
ADA OK
74820-5614
US

IV. Provider business mailing address

114 COLLINS BLVD
ADA OK
74820-7030
US

V. Phone/Fax

Practice location:
  • Phone: 580-272-7591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4036
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number4036
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4036
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4036
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: