=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083763163
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ROBIN STOKES EXUM M.ED. LPC, LCDC, AAC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2208 W 34TH ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77018-6005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-956-6337
-----------------------------------------------------
Fax | 713-956-0320
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10406 CRESCENT MOON DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77064-4346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-955-6553
-----------------------------------------------------
Fax | 713-956-0320
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 60711
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------