Provider Demographics
NPI:1144672619
Name:BLYTHE, ROBYN (LCSW)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:BLYTHE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26100 ALIZIA CANYON DR
Mailing Address - Street 2:#B
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2636
Mailing Address - Country:US
Mailing Address - Phone:818-203-0246
Mailing Address - Fax:
Practice Address - Street 1:26100 ALIZIA CANYON DR
Practice Address - Street 2:#B
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-2636
Practice Address - Country:US
Practice Address - Phone:818-203-0246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-08
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA205621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical