Provider Demographics
NPI:1467649343
Name:MATHY, ROBIN MICHELE (MSW)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:MICHELE
Last Name:MATHY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MICHELLE
Other - Last Name:MATHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:344 N CENTRAL AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-5952
Mailing Address - Country:US
Mailing Address - Phone:619-535-0773
Mailing Address - Fax:619-535-7055
Practice Address - Street 1:344 N CENTRAL AVE APT 9
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-5952
Practice Address - Country:US
Practice Address - Phone:154-169-0120
Practice Address - Fax:307-358-5329
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1324461041C0700X
WYPCSW-2641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical