Individual provider Active NPI

Judith Marie Robinson, L.C.P.C. R.N.C.S.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Evanston, IL
National Provider Identifier
1023183860
Registry record updated Aug 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
0041-306058 Issued in IL
Practice address
708 Church St
Suite 221
Evanston, IL 60201-3875
Phone
(847) 501-1013
NPI assigned
Nov 21, 2006
Last updated
Aug 12, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 0041-306058 IL Primary
Professional Counselor 101YP2500X 180-002949 IL

Addresses

Primary practice location

708 Church St
Suite 221
Evanston, IL 60201-3875

Mailing address

1500 Chicago Ave
Evanston, IL 60201-4428
Phone (847) 424-1236

Other identifiers 1

IdentifierTypeStateIssuer
P00434458OtherILRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
180-002949ILMDProfessional Counselor
0041-306058ILMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1023183860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014428",
            "telephone_number": "847-424-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST",
            "address_2": "SUITE 221",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013875",
            "telephone_number": "847-501-1013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "credential": "L.C.P.C. R.N.C.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "IL",
            "license": "0041-306058",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180-002949",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00434458",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.