Healthcare Provider Details

I. General information

NPI: 1659807642
Provider Name (Legal Business Name): MAYA ROBINSON MS, LPC-S, CST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15712 N PENNSYLVANIA AVE STE 1
EDMOND OK
73013-7327
US

IV. Provider business mailing address

15712 N PENNSYLVANIA AVE STE 1
EDMOND OK
73013-7327
US

V. Phone/Fax

Practice location:
  • Phone: 405-510-0146
  • Fax: 405-276-5297
Mailing address:
  • Phone: 405-464-9985
  • Fax: 405-276-5297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number102295
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number102295
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number7251
License Number StateOK
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7251
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: