MEDICARE: ROBIN SANDERS COUNSELING INC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1619630712
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBIN SANDERS COUNSELING INC

Provider Business Mailing Address
First Line	:	3104 S 70TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3104 S 70TH ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5018
Country	:	US
Telephone Number	:	479-883-2081
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBIN SANDERS
Credential	:	LPC
Telephone Number	:	479-883-2081

Provider Enumeration Date	:	10/16/2021
Last Update Date	:	10/16/2021

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