Provider Demographics
NPI:1043843873
Name:ROBINSON, PRENTISHA (MS LPC)
Entity type:Individual
Prefix:
First Name:PRENTISHA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 LONG CANYON TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75249-1202
Mailing Address - Country:US
Mailing Address - Phone:940-999-0049
Mailing Address - Fax:
Practice Address - Street 1:7301 LONG CANYON TRL
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75249-1202
Practice Address - Country:US
Practice Address - Phone:940-999-0049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80718101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional