Provider Demographics
NPI:1447916093
Name:ROBINSON, M KELLI (LMFT)
Entity type:Individual
Prefix:
First Name:M
Middle Name:KELLI
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 LAUREN DR
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2651
Mailing Address - Country:US
Mailing Address - Phone:859-797-9680
Mailing Address - Fax:
Practice Address - Street 1:228 E REYNOLDS RD STE B6
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-1279
Practice Address - Country:US
Practice Address - Phone:800-464-1958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY105521106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist