MEDICARE: BARBARA ROBINSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1528453131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBARA ROBINSON LCSW

Provider Business Mailing Address
First Line	:	1820 E 17TH ST
Second Line	:	SUITE 330
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-6469
Country	:	US
Telephone Number	:	208-528-7566
Fax Number	:

Provider Business Practice Location Address
First Line	:	3670 S 25TH E
Second Line	:	SUITE 2D
City	:	IDAHO FALLS
State	:	ID
Zip	:	83404-4956
Country	:	US
Telephone Number	:	208-612-2272
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	BARBARA ROBINSON
Credential	:	LCSW
Telephone Number	:	208-612-2272

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	03/31/2015

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