MEDICARE: MRS. DAISY ROBINSON MCILVEEN MED,LPC,LMFT

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	101YP2500X	Professional Counselor	6142	TX
2	106H00000X	Marriage & Family Therapist	06142	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23367660	OTHER		CPS

General Provider Information

NPI Number	:	1821139890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAISY ROBINSON MCILVEEN MED,LPC,LMFT

Provider Business Mailing Address
First Line	:	1501 WOODCREEK DR
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-8793
Country	:	US
Telephone Number	:	979-846-5626
Fax Number	:	979-846-5141

Provider Business Practice Location Address
First Line	:	1501 WOODCREEK DR
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-8793
Country	:	US
Telephone Number	:	979-846-5626
Fax Number	:	979-846-5141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2007
Last Update Date	:	09/11/2025

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