Active NPI
Theodore Edward Robinson, LPC
- Mental Health Counselor
- Broken Arrow, OK
National Provider Identifier
1568658011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6094
- Practice address
- 2035A W Houston St
Broken Arrow, OK 74012-8792 - Phone
- (918) 505-4367
- NPI assigned
- Sep 19, 2007
- 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 | 6094 | OK | Primary |
Addresses
Primary practice location
2035A W Houston St
Broken Arrow, OK 74012-8792
Mailing address
2035A W Houston St
Broken Arrow, OK 74012-8792
Phone (918) 851-7190
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 23, 2024 through Aug 23, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6094 | OK | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665619200000",
"number": "1568658011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2035A W HOUSTON ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740128792",
"telephone_number": "918-851-7190",
"fax_number": "918-560-1399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2035A W HOUSTON ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740128792",
"telephone_number": "918-505-4367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBINSON",
"first_name": "THEODORE",
"middle_name": "EDWARD",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-19",
"last_updated": "2022-10-13",
"certification_date": "2022-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OK",
"license": "6094",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.