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General NPI Number Information
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NPI Number | 1649157421
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Entity Type | Individual
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Provider Name | ROBYN DYKSTRA LCSW, PMH-C
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 2114 25TH ST STE A
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City | COLUMBUS
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State | IN
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Zip | 47201-3239
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Country | US
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Telephone | 812-372-1581
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 775383
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City | CHICAGO
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State | IL
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Zip | 60677-5383
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Country | US
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Telephone | 812-376-5315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34011000A
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License Number State | IN
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