Active NPI
Charles Watson Robinson III, LADC-MH
- Mental Health Counselor
- Edmond, OK
National Provider Identifier
1033689203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1236
- Practice address
- 1401 NW 150TH St Ste B
Edmond, OK 73013-2169 - Phone
- (405) 823-1356
- NPI assigned
- Nov 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1236 | OK | Primary |
Addresses
Primary practice location
1401 NW 150TH St Ste B
Edmond, OK 73013-2169
Mailing address
PO Box 1640
Edmond, OK 73083-1640
Phone (405) 823-1356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 31, 2024 through May 31, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1033689203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1640",
"city": "EDMOND",
"state": "OK",
"postal_code": "730831640",
"telephone_number": "405-823-1356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 NW 150TH ST STE B",
"city": "EDMOND",
"state": "OK",
"postal_code": "730132169",
"telephone_number": "405-823-1356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "CHARLES",
"middle_name": "WATSON",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LADC-MH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-30",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "1236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.