Provider Demographics
NPI:1447220801
Name:FOX, ROBIN D (PMHNP-BC, LPC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:FOX
Suffix:
Gender:
Credentials:PMHNP-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1162
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-0092
Mailing Address - Country:US
Mailing Address - Phone:541-669-0655
Mailing Address - Fax:541-714-1075
Practice Address - Street 1:547 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-4909
Practice Address - Country:US
Practice Address - Phone:541-669-0655
Practice Address - Fax:541-714-1075
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID101Y00000X
IDNP 189-A363LP0808X, 363LX0001X
OR201709886NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID000010141286OtherREGENCE BLUE SHIELD OF ID
IDNPBG3OtherBLUE CROSS OF ID
ID004366200Medicaid
IDNPBG3OtherBLUE CROSS OF ID
ID500029162Medicare ID - Type UnspecifiedRAILROAD MEDICARE
ID1341957Medicare ID - Type Unspecified